Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for J9038. 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
$48.09 - $59.85
J9038 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arkansas | $59.85 | -- | -- | 2026 |
| Arizona | $51.38 | -- | -- | 2026 |
| California | $55.65 | -- | -- | 2026 |
| Connecticut | $55.65 | -- | -- | 2026 |
| District of Columbia | $55.65 | -- | Required | 2026 |
| Idaho | $48.09 | -- | Not required | 2026 |
| Illinois | $54.15 | -- | -- | 2026 |
| Kansas | $56.46 | -- | -- | 2026 |
| Maine | $56.46 | -- | -- | 2026 |
| Michigan | $56.46 | -- | -- | 2026 |
| Minnesota | $56.46 | -- | Required | 2026 |
| Mississippi | $55.65 | -- | -- | 2026 |
| Montana | $55.65 | -- | -- | 2026 |
| Nebraska | $56.46 | -- | -- | 2026 |
| New Hampshire | $53.30 | -- | Not required | 2026 |
| New Jersey | $51.98 | -- | Not required | 2026 |
| Oklahoma | $56.46 | -- | -- | 2026 |
| Rhode Island | $57.49 | -- | -- | 2026 |
| South Carolina | $54.67 | -- | -- | 2026 |
| Texas | $53.55* | -- | -- | 2026 |
| Utah | $56.46* | -- | Required | 2026 |
| Virginia | $56.46 | -- | -- | 2026 |
| Vermont | $52.87 | -- | Required | 2026 |
| Wisconsin | $56.46 | -- | -- | 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 198 codes from J9000 to J9601 or every drugs code by number.
Frequently asked questions
How much does Medicaid pay for J9038?
24 state Medicaid programs publish a fee-for-service rate for J9038 (injection, axatilimab-csfr, 0.1 mg), ranging from $48.09 in Idaho to $59.85 in Arkansas. The full table on this page lists every publishing state's current rate.
Which state pays the most for J9038?
Arkansas publishes the highest Medicaid rate for J9038 at $59.85. Idaho publishes the lowest at $48.09.
Does J9038 require prior authorization under Medicaid?
4 of the 24 publishing states flag J9038 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".