Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for Q9997. 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
23
Median % of Medicare
--
Rate range
$4.41 - $9.60
Q9997 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alabama | $9.29 | -- | -- | 2026 |
| Arkansas | $8.82* | -- | -- | 2026 |
| California | $4.53 | -- | -- | 2026 |
| Connecticut | $8.27 | -- | -- | 2026 |
| District of Columbia | $8.27 | -- | Required | 2026 |
| Idaho | $7.14 | -- | Required | 2026 |
| Illinois | $4.41 | -- | -- | 2026 |
| Kansas | $8.55 | -- | -- | 2026 |
| Kentucky | $8.27 | -- | -- | 2026 |
| Michigan | $8.55 | -- | -- | 2026 |
| Minnesota | $8.39 | -- | Required | 2026 |
| Montana | $8.27 | -- | -- | 2026 |
| Nebraska | $8.55 | -- | -- | 2026 |
| New Hampshire | $8.46 | -- | Not required | 2026 |
| New Jersey | $8.72 | -- | Not required | 2026 |
| Oklahoma | $8.55 | -- | -- | 2026 |
| Rhode Island | $9.60 | -- | -- | 2026 |
| South Carolina | $8.55 | -- | -- | 2026 |
| Texas | $8.63* | -- | -- | 2025 |
| Utah | $8.55* | -- | Required | 2026 |
| Vermont | $8.83 | -- | Required | 2026 |
| Washington | $8.55 | -- | -- | 2026 |
| Wisconsin | $8.55 | -- | -- | 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 22 codes from Q9950 to Q9999 or every state-specific services code by number.
Frequently asked questions
How much does Medicaid pay for Q9997?
23 state Medicaid programs publish a fee-for-service rate for Q9997 (injection, ustekinumab-ttwe (pyzchiva), intravenous, 1 mg), ranging from $4.41 in Illinois to $9.60 in Rhode Island. The full table on this page lists every publishing state's current rate.
Which state pays the most for Q9997?
Rhode Island publishes the highest Medicaid rate for Q9997 at $9.60. Illinois publishes the lowest at $4.41.
Does Q9997 require prior authorization under Medicaid?
5 of the 23 publishing states flag Q9997 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".