Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for J1931. 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
30
Median % of Medicare
--
Rate range
$22.74 - $41.92
J1931 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alabama | $39.87 | -- | -- | 2026 |
| Arkansas | $22.74 | -- | -- | 2026 |
| Arizona | $36.69 | -- | -- | 2026 |
| California | $39.95 | -- | -- | 2026 |
| Connecticut | $39.95 | -- | -- | 2026 |
| Iowa | $35.95 | -- | -- | 2024 |
| Idaho | $34.52 | -- | Required | 2026 |
| Illinois | $38.88 | -- | -- | 2026 |
| Indiana | $41.92 | -- | -- | 2026 |
| Kansas | $41.49 | -- | -- | 2026 |
| Kentucky | $39.95 | -- | -- | 2026 |
| Michigan | $41.49 | -- | -- | 2026 |
| Minnesota | $37.65 | -- | -- | 2024 |
| Mississippi | $39.95 | -- | -- | 2026 |
| Montana | $39.95 | -- | -- | 2026 |
| North Carolina | $41.49 | -- | -- | 2026 |
| Nebraska | $41.48 | -- | -- | 2026 |
| New Hampshire | $39.90 | -- | Not required | 2026 |
| New Jersey | $24.63 | -- | Not required | 2026 |
| New Mexico | $38.62 | -- | -- | 2025 |
| Oklahoma | $41.49 | -- | -- | 2026 |
| Rhode Island | $33.26 | -- | -- | 2026 |
| South Carolina | $40.20 | -- | -- | 2026 |
| Texas | $39.88* | -- | -- | 2026 |
| Utah | $41.49* | -- | Required | 2026 |
| Virginia | $41.48 | -- | -- | 2026 |
| Vermont | $37.88 | -- | -- | 2026 |
| Washington | $41.49 | -- | -- | 2026 |
| Wisconsin | $41.49 | -- | -- | 2026 |
| Wyoming | $41.49 | -- | -- | 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 J1931?
30 state Medicaid programs publish a fee-for-service rate for J1931 (injection, laronidase, 0.1 mg), ranging from $22.74 in Arkansas to $41.92 in Indiana. The full table on this page lists every publishing state's current rate.
Which state pays the most for J1931?
Indiana publishes the highest Medicaid rate for J1931 at $41.92. Arkansas publishes the lowest at $22.74.
Does J1931 require prior authorization under Medicaid?
2 of the 30 publishing states flag J1931 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".