Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for Q5157. 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
21
Median % of Medicare
--
Rate range
$25.49 - $32.49
Q5157 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arkansas | $32.49 | -- | -- | 2026 |
| Arizona | $26.72 | -- | -- | 2026 |
| California | $30.67 | -- | -- | 2026 |
| Illinois | $25.50 | -- | -- | 2026 |
| Indiana | $28.92 | -- | Required | 2025 |
| Kansas | $25.98 | -- | -- | 2026 |
| Maine | $25.98 | -- | -- | 2026 |
| Michigan | $25.98 | -- | -- | 2026 |
| Minnesota | $25.49 | -- | Required | 2026 |
| Mississippi | $26.21 | -- | -- | 2026 |
| Montana | $26.21 | -- | -- | 2026 |
| Nebraska | $25.97 | -- | -- | 2026 |
| New Hampshire | $29.69 | -- | Not required | 2026 |
| New Jersey | $28.61 | -- | Not required | 2026 |
| Oklahoma | $25.98 | -- | -- | 2026 |
| South Carolina | $25.98 | -- | -- | 2026 |
| Texas | $29.33* | -- | -- | 2026 |
| Utah | $25.98* | -- | Required | 2026 |
| Virginia | $25.49 | -- | -- | 2026 |
| Washington | $25.98 | -- | -- | 2026 |
| Wisconsin | $25.98 | -- | -- | 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 Q5157?
21 state Medicaid programs publish a fee-for-service rate for Q5157 (injection, denosumab-bmwo (stoboclo/osenvelt), biosimilar, 1 mg), ranging from $25.49 in Virginia to $32.49 in Arkansas. The full table on this page lists every publishing state's current rate.
Which state pays the most for Q5157?
Arkansas publishes the highest Medicaid rate for Q5157 at $32.49. Virginia publishes the lowest at $25.49.
Does Q5157 require prior authorization under Medicaid?
3 of the 21 publishing states flag Q5157 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".