Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for J9042. 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
32
Median % of Medicare
--
Rate range
$95.83 - $279.21
J9042 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alabama | $258.64 | -- | -- | 2026 |
| Arkansas | $106.86 | -- | -- | 2026 |
| Arizona | $236.48 | -- | -- | 2026 |
| California | $268.73 | -- | -- | 2026 |
| Connecticut | $268.45 | -- | -- | 2026 |
| District of Columbia | $268.45 | -- | Required | 2026 |
| Iowa | $220.34 | -- | -- | 2024 |
| Idaho | $231.95 | -- | Not required | 2026 |
| Illinois | $261.47 | -- | -- | 2026 |
| Indiana | $276.57 | -- | -- | 2026 |
| Kansas | $279.21 | -- | -- | 2026 |
| Kentucky | $268.45 | -- | -- | 2026 |
| Louisiana | $248.93 | -- | -- | 2026 |
| Maine | $279.21 | -- | -- | 2026 |
| Michigan | $279.21 | -- | -- | 2026 |
| Minnesota | $279.20 | -- | Required | 2026 |
| Mississippi | $268.73 | -- | -- | 2026 |
| Montana | $268.45 | -- | -- | 2026 |
| Nebraska | $279.20 | -- | -- | 2026 |
| New Hampshire | $263.40 | -- | Not required | 2026 |
| New Jersey | $95.83 | -- | Not required | 2026 |
| New Mexico | $248.93 | -- | -- | 2025 |
| Oklahoma | $279.21 | -- | -- | 2026 |
| Rhode Island | $162.48 | -- | -- | 2026 |
| South Carolina | $267.53 | -- | -- | 2026 |
| Texas | $258.52* | -- | -- | 2026 |
| Utah | $279.21* | -- | Required | 2026 |
| Virginia | $279.20* | -- | -- | 2026 |
| Vermont | $245.71 | -- | -- | 2026 |
| Washington | $279.21 | -- | -- | 2026 |
| Wisconsin | $279.21 | -- | -- | 2026 |
| Wyoming | $205.76 | -- | -- | 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 198 codes from J9000 to J9601 or every drugs code by number.
Frequently asked questions
How much does Medicaid pay for J9042?
32 state Medicaid programs publish a fee-for-service rate for J9042 (injection, brentuximab vedotin, 1 mg), ranging from $95.83 in New Jersey to $279.21 in Kansas. The full table on this page lists every publishing state's current rate.
Which state pays the most for J9042?
Kansas publishes the highest Medicaid rate for J9042 at $279.21. New Jersey publishes the lowest at $95.83.
Does J9042 require prior authorization under Medicaid?
3 of the 32 publishing states flag J9042 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".