Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for J9358. 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
$22.73 - $34.03
J9358 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alabama | $29.98 | -- | -- | 2026 |
| Arkansas | $24.19 | -- | -- | 2026 |
| Arizona | $27.37 | -- | -- | 2026 |
| California | $31.26 | -- | -- | 2026 |
| Connecticut | $31.30 | -- | -- | 2026 |
| District of Columbia | $31.30 | -- | Required | 2026 |
| Iowa | $26.83 | -- | -- | 2024 |
| Idaho | $27.04 | -- | Not required | 2026 |
| Illinois | $30.42 | -- | -- | 2026 |
| Indiana | $34.03 | -- | -- | 2026 |
| Kansas | $32.87 | -- | -- | 2026 |
| Kentucky | $31.30 | -- | -- | 2026 |
| Louisiana | $28.81 | -- | -- | 2026 |
| Maine | $32.87 | -- | -- | 2026 |
| Michigan | $32.87 | -- | -- | 2026 |
| Minnesota | $32.87 | -- | Required | 2026 |
| Mississippi | $31.26 | -- | -- | 2026 |
| Montana | $31.30 | -- | -- | 2026 |
| Nebraska | $32.87 | -- | -- | 2026 |
| New Hampshire | $32.41 | -- | Not required | 2026 |
| New Jersey | $22.73 | -- | Not required | 2026 |
| New Mexico | $28.81 | -- | -- | 2025 |
| Oklahoma | $32.87 | -- | -- | 2026 |
| Rhode Island | $29.81 | -- | -- | 2026 |
| South Carolina | $32.87 | -- | -- | 2026 |
| Texas | $30.00* | -- | -- | 2026 |
| Utah | $32.87* | -- | Not required | 2026 |
| Virginia | $32.87* | -- | -- | 2026 |
| Vermont | $28.48 | -- | Required | 2026 |
| Washington | $32.87 | -- | -- | 2026 |
| Wisconsin | $32.87 | -- | -- | 2026 |
| Wyoming | $32.87 | -- | -- | 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 J9358?
32 state Medicaid programs publish a fee-for-service rate for J9358 (injection, fam-trastuzumab deruxtecan-nxki, 1 mg), ranging from $22.73 in New Jersey to $34.03 in Indiana. The full table on this page lists every publishing state's current rate.
Which state pays the most for J9358?
Indiana publishes the highest Medicaid rate for J9358 at $34.03. New Jersey publishes the lowest at $22.73.
Does J9358 require prior authorization under Medicaid?
3 of the 32 publishing states flag J9358 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".