Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for Q0177. 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
14
Median % of Medicare
--
Rate range
$0.03 - $0.31
Q0177 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arizona | $0.13 | -- | -- | 2026 |
| Idaho | $0.03 | -- | Not required | 2025 |
| Illinois | $0.05 | -- | -- | 2026 |
| Indiana | $0.08 | -- | -- | 2011 |
| Minnesota | $0.06 | -- | -- | 2026 |
| Montana | $0.04 | -- | -- | 2026 |
| New Hampshire | $0.08 | -- | Not required | 2026 |
| New Jersey | $0.31 | -- | Not required | 2026 |
| New Mexico | $0.04 | -- | -- | 2025 |
| Oklahoma | $0.07 | -- | -- | 2026 |
| Texas | $0.26* | -- | -- | 2025 |
| Virginia | $0.04 | -- | -- | 2010 |
| Washington | $0.04 | -- | -- | 2026 |
| Wisconsin | $0.04 | -- | -- | 2011 |
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
- C1716 - Brachytherapy source, non-stranded, gold-198, per source
- C1717 - Brachytherapy source, non-stranded, high dose rate iridium-192, per source
- C1719 - Brachytherapy source, non-stranded, non-high dose rate iridium-192, per source
- C2616 - Brachytherapy source, non-stranded, yttrium-90, per source
- C2634 - Brachytherapy source, non-stranded, high activity, iodine-125, greater than 1.01 mci (nist), per source
- C2635 - Brachytherapy source, non-stranded, high activity, palladium-103, greater than 2.2 mci (nist), per source
- C2636 - Brachytherapy linear source, non-stranded, palladium-103, per 1 mm
- C2638 - Brachytherapy source, stranded, iodine-125, per source
All 52 codes from Q0035 to Q0506 or every state-specific services code by number.
Frequently asked questions
How much does Medicaid pay for Q0177?
14 state Medicaid programs publish a fee-for-service rate for Q0177 (hydroxyzine pamoate, 25 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 $0.03 in Idaho to $0.31 in New Jersey. The full table on this page lists every publishing state's current rate.
Which state pays the most for Q0177?
New Jersey publishes the highest Medicaid rate for Q0177 at $0.31. Idaho publishes the lowest at $0.03.
Does Q0177 require prior authorization under Medicaid?
No publishing state flags Q0177 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.