Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for J7520. 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
22
Median % of Medicare
--
Rate range
$0.74 - $11.86
J7520 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arkansas | $6.38 | -- | -- | 2026 |
| Arizona | $0.74 | -- | -- | 2026 |
| Connecticut | $2.67 | -- | -- | 2024 |
| District of Columbia | $0.97 | -- | Not required | 2026 |
| Iowa | $11.86 | -- | -- | 2024 |
| Idaho | $0.84 | -- | Not required | 2026 |
| Indiana | $3.94 | -- | -- | 2025 |
| Maine | $0.74 | -- | -- | 2026 |
| Minnesota | $0.74 | -- | -- | 2026 |
| Montana | $0.97 | -- | -- | 2026 |
| New Hampshire | $4.50 | -- | Not required | 2026 |
| New Jersey | $7.97 | -- | Not required | 2026 |
| New Mexico | $1.06 | -- | -- | 2025 |
| Oklahoma | $0.74 | -- | -- | 2026 |
| Rhode Island | $11.35 | -- | -- | 2026 |
| South Carolina | $0.77 | -- | -- | 2026 |
| Utah | $9.35* | -- | Not required | 2022 |
| Virginia | $0.74 | -- | -- | 2026 |
| Vermont | $0.83 | -- | -- | 2026 |
| Washington | $0.74 | -- | -- | 2026 |
| Wisconsin | $0.74 | -- | -- | 2026 |
| Wyoming | $3.42 | -- | -- | 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 J7520?
22 state Medicaid programs publish a fee-for-service rate for J7520 (sirolimus, oral, 1 mg), ranging from $0.74 in Wisconsin to $11.86 in Iowa. The full table on this page lists every publishing state's current rate.
Which state pays the most for J7520?
Iowa publishes the highest Medicaid rate for J7520 at $11.86. Wisconsin publishes the lowest at $0.74.
Does J7520 require prior authorization under Medicaid?
No publishing state flags J7520 with a prior-authorization indicator on its fee schedule. Absence of a flag means the state publishes none, not that PA is never required - confirm through the state's provider manual.