Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for J9204. 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
$187.54 - $258.54
J9204 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alabama | $248.50 | -- | -- | 2026 |
| Arkansas | $200.87 | -- | -- | 2026 |
| Arizona | $231.15 | -- | -- | 2026 |
| California | $253.47 | -- | -- | 2026 |
| Connecticut | $253.47 | -- | -- | 2026 |
| District of Columbia | $253.47 | -- | Required | 2026 |
| Iowa | $223.74 | -- | -- | 2024 |
| Idaho | $219.00 | -- | Required | 2026 |
| Illinois | $246.62 | -- | -- | 2026 |
| Indiana | $256.10 | -- | -- | 2026 |
| Kansas | $258.54 | -- | -- | 2026 |
| Kentucky | $253.47 | -- | -- | 2026 |
| Louisiana | $234.17 | -- | -- | 2026 |
| Maine | $258.54 | -- | -- | 2026 |
| Michigan | $258.54 | -- | -- | 2026 |
| Minnesota | $187.54 | -- | Required | 2024 |
| Mississippi | $253.47 | -- | -- | 2026 |
| Montana | $253.47 | -- | -- | 2026 |
| Nebraska | $258.53 | -- | -- | 2026 |
| New Hampshire | $242.40 | -- | Not required | 2026 |
| New Jersey | $187.61 | -- | Not required | 2026 |
| New Mexico | $243.32 | -- | -- | 2025 |
| Oklahoma | $258.54 | -- | -- | 2026 |
| Rhode Island | $254.52 | -- | -- | 2026 |
| South Carolina | $248.80 | -- | -- | 2026 |
| Texas | $248.50* | -- | -- | 2026 |
| Utah | $258.54* | -- | Not required | 2026 |
| Virginia | $258.53* | -- | -- | 2026 |
| Vermont | $236.08 | -- | Required | 2026 |
| Washington | $258.54 | -- | -- | 2026 |
| Wisconsin | $258.54 | -- | -- | 2026 |
| Wyoming | $258.54 | -- | -- | 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 J9204?
32 state Medicaid programs publish a fee-for-service rate for J9204 (injection, mogamulizumab-kpkc, 1 mg), ranging from $187.54 in Minnesota to $258.54 in Kansas. The full table on this page lists every publishing state's current rate.
Which state pays the most for J9204?
Kansas publishes the highest Medicaid rate for J9204 at $258.54. Minnesota publishes the lowest at $187.54.
Does J9204 require prior authorization under Medicaid?
4 of the 32 publishing states flag J9204 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".