Q0169 Medicaid Rate by State

Promethazine hydrochloride, 12.5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen

17 state Medicaid programs publish a fee-for-service rate for Q0169 (promethazine hydrochloride, 12.5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen), ranging from $0.02 in Washington to $0.48 in Texas.

Every state, kept current

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This page shows one representative rate per state for Q0169. Full schedules include every locality, modifier, and age-band variant.

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Publishing states

17

Median % of Medicare

--

Rate range

$0.02 - $0.48

Q0169 rates in every publishing state

StateMedicaid rate% of MedicarePrior authVintage
Arizona$0.08----2026
Idaho$0.08--Not required2025
Illinois$0.04----2026
Indiana$0.05----2015
Minnesota$0.04----2026
Montana$0.04----2026
Nebraska$0.09----2026
New Hampshire$0.07--Not required2026
New Jersey$0.43--Not required2026
New Mexico$0.04----2025
Oklahoma$0.05----2026
South Carolina$0.21----2023
Texas$0.48*----2025
Virginia$0.03----2019
Washington$0.02----2026
Wisconsin$0.04----2019
Wyoming$0.04----2019

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 state-specific services codes

All 52 codes from Q0035 to Q0506 or every state-specific services code by number.

Frequently asked questions

How much does Medicaid pay for Q0169?

17 state Medicaid programs publish a fee-for-service rate for Q0169 (promethazine hydrochloride, 12.5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen), ranging from $0.02 in Washington to $0.48 in Texas. The full table on this page lists every publishing state's current rate.

Which state pays the most for Q0169?

Texas publishes the highest Medicaid rate for Q0169 at $0.48. Washington publishes the lowest at $0.02.

Does Q0169 require prior authorization under Medicaid?

No publishing state flags Q0169 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.