Q0224 Medicaid Rate by State

Injection, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, and who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive medications or treatments, and are unlikely to mount an adequate immune response to covid-19 vaccination, 4500 mg

16 state Medicaid programs publish a fee-for-service rate for Q0224 (injection, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, and who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive medications or treatments, and are unlikely to mount an adequate immune response to covid-19 vaccination, 4500 mg), ranging from $6,583.50 in New Mexico to $7,239.00 in Arizona.

Every state, kept current

The Rates plan

$29/mo7-day free trial

This page shows one representative rate per state for Q0224. 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
Start free trial

$29/mo after the trial. Cancel anytime.

Publishing states

16

Median % of Medicare

--

Rate range

$6,583.50 - $7,239.00

Q0224 rates in every publishing state

StateMedicaid rate% of MedicarePrior authVintage
Arizona$7,239.00----2026
California$7,239.00----2026
Connecticut$7,239.00----2026
District of Columbia$7,239.00--Not required2026
Indiana$6,667.50----2025
Kansas$7,239.00----2025
Maryland$7,239.00----2024
Maine$7,239.00----2026
Mississippi$7,239.00----2026
Montana$7,239.00----2026
North Carolina$7,239.00----2025
New Jersey$6,583.50--Not required2026
New Mexico$6,583.50----2024
Utah$7,239.00*--Not required2025
Virginia$7,239.00----2025
Wisconsin$7,239.00----2025

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 Q0224?

16 state Medicaid programs publish a fee-for-service rate for Q0224 (injection, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, and who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive medications or treatments, and are unlikely to mount an adequate immune response to covid-19 vaccination, 4500 mg), ranging from $6,583.50 in New Mexico to $7,239.00 in Arizona. The full table on this page lists every publishing state's current rate.

Which state pays the most for Q0224?

Arizona publishes the highest Medicaid rate for Q0224 at $7,239.00. New Mexico publishes the lowest at $6,583.50.

Does Q0224 require prior authorization under Medicaid?

No publishing state flags Q0224 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.