Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for J7201. 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
27
Median % of Medicare
--
Rate range
$2.82 - $4.10
J7201 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arkansas | $2.82 | -- | -- | 2026 |
| Arizona | $3.40 | -- | -- | 2026 |
| Connecticut | $3.60 | -- | -- | 2026 |
| District of Columbia | $3.60 | -- | Required | 2026 |
| Idaho | $3.11 | -- | Not required | 2026 |
| Illinois | $3.48 | -- | -- | 2026 |
| Kansas | $3.71 | -- | -- | 2026 |
| Kentucky | $3.60 | -- | -- | 2026 |
| Maine | $3.71 | -- | -- | 2026 |
| Michigan | $3.71 | -- | -- | 2026 |
| Minnesota | $3.34 | -- | -- | 2026 |
| Mississippi | $3.58 | -- | -- | 2026 |
| Montana | $3.60 | -- | -- | 2026 |
| North Carolina | $2.96* | -- | -- | 2025 |
| Nebraska | $3.71 | -- | -- | 2026 |
| New Hampshire | $4.04 | -- | Not required | 2026 |
| New Jersey | $2.82 | -- | Not required | 2026 |
| New Mexico | $3.58 | -- | -- | 2025 |
| Oklahoma | $3.71 | -- | -- | 2026 |
| Rhode Island | $4.10 | -- | -- | 2026 |
| Texas | $3.63* | -- | -- | 2026 |
| Utah | $3.71* | -- | Not required | 2026 |
| Virginia | $3.71 | -- | -- | 2026 |
| Vermont | $3.41 | -- | Required | 2026 |
| Washington | $3.47 | -- | -- | 2026 |
| Wisconsin | $3.71 | -- | -- | 2026 |
| Wyoming | $3.36 | -- | -- | 2022 |
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 137 codes from J7030 to J7686 or every drugs code by number.
Frequently asked questions
How much does Medicaid pay for J7201?
27 state Medicaid programs publish a fee-for-service rate for J7201 (injection, factor ix, fc fusion protein, (recombinant), alprolix, 1 i.u.), ranging from $2.82 in New Jersey to $4.10 in Rhode Island. The full table on this page lists every publishing state's current rate.
Which state pays the most for J7201?
Rhode Island publishes the highest Medicaid rate for J7201 at $4.10. New Jersey publishes the lowest at $2.82.
Does J7201 require prior authorization under Medicaid?
2 of the 27 publishing states flag J7201 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".