Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for J1809. Full schedules include every locality, modifier, and age-band variant.
- Every code on all 51 published schedules
- Full-schedule CSV export and state network lists
- Email alerts when a state changes its rates
$29/mo after the trial. Cancel anytime.
Publishing states
24
Median % of Medicare
--
Rate range
$14.89 - $17.93
J1809 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arkansas | $16.12* | -- | -- | 2026 |
| Arizona | $16.12 | -- | -- | 2026 |
| California | $17.59 | -- | -- | 2026 |
| Connecticut | $17.24 | -- | Required | 2026 |
| District of Columbia | $17.24 | -- | Not required | 2026 |
| Idaho | $14.89 | -- | Required | 2026 |
| Illinois | $17.11 | -- | -- | 2026 |
| Indiana | $17.93 | -- | -- | 2025 |
| Kansas | $17.74 | -- | -- | 2026 |
| Michigan | $17.74 | -- | -- | 2026 |
| Minnesota | $17.73 | -- | Required | 2026 |
| Mississippi | $17.59 | -- | -- | 2026 |
| Montana | $17.24 | -- | -- | 2026 |
| Nebraska | $17.73 | -- | -- | 2026 |
| New Hampshire | $17.07 | -- | Not required | 2026 |
| New Jersey | $16.90 | -- | Not required | 2026 |
| Oklahoma | $17.74 | -- | -- | 2026 |
| Rhode Island | $17.53 | -- | -- | 2026 |
| Texas | $16.97* | -- | -- | 2025 |
| Utah | $17.74* | -- | Required | 2026 |
| Virginia | $17.73 | -- | -- | 2026 |
| Vermont | $16.12 | -- | Required | 2026 |
| Washington | $17.74 | -- | -- | 2026 |
| Wisconsin | $17.74 | -- | -- | 2026 |
Published Medicaid fee-for-service schedule amounts, not a coverage or eligibility guarantee. Managed-care plan rates can differ. Where no prior-authorization flag is shown, the state does not publish one. Rows marked * are representative published variants or methodology-derived rates. "--" in the prior-auth column means the state publishes no PA flag.
Related drugs codes
- J0013 - Esketamine, nasal spray, 1 mg
- J0120 - Injection, tetracycline, up to 250 mg
- J0121 - Injection, omadacycline, 1 mg
- J0122 - Injection, eravacycline, 1 mg
- J0129 - Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)
- J0130 - Injection abciximab, 10 mg
- J0131 - Injection, acetaminophen, not otherwise specified,10 mg
- J0132 - Injection, acetylcysteine, 100 mg
All 194 codes from J1000 to J1980 or every drugs code by number.
Frequently asked questions
How much does Medicaid pay for J1809?
24 state Medicaid programs publish a fee-for-service rate for J1809 (injection, fosdenopterin, 0.1 mg), ranging from $14.89 in Idaho to $17.93 in Indiana. The full table on this page lists every publishing state's current rate.
Which state pays the most for J1809?
Indiana publishes the highest Medicaid rate for J1809 at $17.93. Idaho publishes the lowest at $14.89.
Does J1809 require prior authorization under Medicaid?
5 of the 24 publishing states flag J1809 as requiring prior authorization (always or conditionally) on their fee schedules. States without a flag publish no PA indicator for this code - that means "not published", not "no PA required".