Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for Q5128. 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
30
Median % of Medicare
--
Rate range
$40.00 - $385.60
Q5128 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alabama | $86.16 | -- | -- | 2026 |
| Arkansas | $310.08 | -- | -- | 2026 |
| Arizona | $160.30 | -- | -- | 2026 |
| California | $83.48 | -- | -- | 2026 |
| Connecticut | $262.08 | -- | -- | 2024 |
| District of Columbia | $83.34 | -- | Required | 2026 |
| Iowa | $275.48 | -- | -- | 2024 |
| Idaho | $72.01 | -- | Not required | 2026 |
| Illinois | $81.22 | -- | -- | 2026 |
| Indiana | $385.60 | -- | -- | 2023 |
| Kansas | $82.53 | -- | -- | 2026 |
| Kentucky | $83.34 | -- | -- | 2026 |
| Michigan | $82.53 | -- | -- | 2026 |
| Minnesota | $83.47 | -- | Required | 2026 |
| Mississippi | $83.48 | -- | -- | 2026 |
| Montana | $83.34 | -- | -- | 2026 |
| Nebraska | $42.72 | -- | -- | 2026 |
| New Hampshire | $40.00 | -- | Not required | 2026 |
| New Jersey | $269.28 | -- | Not required | 2026 |
| New Mexico | $168.74 | -- | -- | 2025 |
| Oklahoma | $83.48 | -- | -- | 2026 |
| Rhode Island | $308.39 | -- | -- | 2026 |
| South Carolina | $82.53 | -- | -- | 2026 |
| Texas | $86.51* | -- | -- | 2026 |
| Utah | $82.53* | -- | Not required | 2026 |
| Virginia | $83.47* | -- | -- | 2026 |
| Vermont | $81.85 | -- | -- | 2026 |
| Washington | $83.48 | -- | -- | 2026 |
| Wisconsin | $82.53 | -- | -- | 2026 |
| Wyoming | $82.53 | -- | -- | 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 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 56 codes from Q5098 to Q5167 or every state-specific services code by number.
Frequently asked questions
How much does Medicaid pay for Q5128?
30 state Medicaid programs publish a fee-for-service rate for Q5128 (injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg), ranging from $40.00 in New Hampshire to $385.60 in Indiana. The full table on this page lists every publishing state's current rate.
Which state pays the most for Q5128?
Indiana publishes the highest Medicaid rate for Q5128 at $385.60. New Hampshire publishes the lowest at $40.00.
Does Q5128 require prior authorization under Medicaid?
2 of the 30 publishing states flag Q5128 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".