Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for J1813. 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
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Publishing states
20
Median % of Medicare
--
Rate range
$4.12 - $19.56
J1813 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arizona | $4.80 | -- | -- | 2026 |
| California | $19.56 | -- | -- | 2026 |
| Connecticut | $15.57 | -- | -- | 2024 |
| District of Columbia | $15.10 | -- | Not required | 2026 |
| Idaho | $13.05 | -- | Not required | 2026 |
| Illinois | $14.70 | -- | -- | 2026 |
| Indiana | $14.42 | -- | Required | 2023 |
| Kansas | $4.80 | -- | -- | 2026 |
| Michigan | $4.80 | -- | -- | 2026 |
| Mississippi | $15.10 | -- | -- | 2026 |
| Montana | $15.10 | -- | -- | 2026 |
| Nebraska | $4.80 | -- | -- | 2026 |
| New Hampshire | $4.12 | -- | Not required | 2026 |
| New Jersey | $13.60 | -- | Not required | 2026 |
| New Mexico | $15.48 | -- | -- | 2025 |
| Oklahoma | $4.80 | -- | -- | 2026 |
| South Carolina | $4.80 | -- | -- | 2026 |
| Utah | $4.80* | -- | Required | 2026 |
| Vermont | $14.36 | -- | Required | 2026 |
| Wisconsin | $4.80 | -- | -- | 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 J1813?
20 state Medicaid programs publish a fee-for-service rate for J1813 (insulin (lyumjev) for administration through dme (i.e., insulin pump) per 50 units), ranging from $4.12 in New Hampshire to $19.56 in California. The full table on this page lists every publishing state's current rate.
Which state pays the most for J1813?
California publishes the highest Medicaid rate for J1813 at $19.56. New Hampshire publishes the lowest at $4.12.
Does J1813 require prior authorization under Medicaid?
3 of the 20 publishing states flag J1813 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".