The Rates plan
$29/mo7-day free trialThe table on this page is a common-procedure sample. The full Idaho drugs schedule has 876 codes.
- Every code on all 51 published schedules
- Full-schedule CSV export
- Full state Medicaid dental network lists
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Published codes
876
Drugs procedures on the 2026 schedule
Median % of Medicare
--
no national Medicare comparator for this category
PA required
151
codes flagged by the state
Common drugs procedures and what Idaho Medicaid pays
A curated sample of recognizable procedures from the 876-code schedule. Rates are the state's published fee-for-service amounts; the percentage compares each rate with the national Medicare amount for the same code.
| Code | Procedure | Idaho rate | % of Medicare |
|---|---|---|---|
| J0696 | Injection, ceftriaxone sodium, per 250 mg | $0.40 | -- |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | $0.09 | -- |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | $0.29 | -- |
| J2550 | Injection, promethazine hcl, up to 50 mg | $3.43 | -- |
| J3420 | Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg | $0.55 | -- |
| J7030 | Infusion, normal saline solution , 1000 cc | $1.72 | -- |
| J7613 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg | $0.07 | -- |
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 * show the schedule's representative published variant.
More Idaho Medicaid fee schedules
- Idaho physician fee schedule · 6,717 codes
- Idaho lab & imaging fee schedule · 2,129 codes
- Idaho dme & supplies fee schedule · 2,014 codes
- Idaho other services fee schedule · 394 codes
- Idaho vision fee schedule · 146 codes
- Idaho hearing fee schedule · 30 codes
Drugs rates in neighboring states
Frequently asked questions
What does Idaho Medicaid pay for physician-administered drugs?
Idaho Medicaid publishes 876 drugs procedure rates effective 2026 on its fee-for-service schedule. The schedule covers injectable and infused medications billed under HCPCS J-codes. The table on this page shows published rates for common procedures; the complete all-codes schedule is available as a CSV download with a ProviderSignal Rates subscription.
How do Idaho's drugs rates compare with Medicare?
Most drugs codes in this category have no direct national Medicare comparator (Medicare prices these services through different mechanisms), so a median comparison is not published here.
Do drugs services need prior authorization in Idaho?
Idaho publishes prior-authorization flags on its schedule: 151 drugs codes are marked as always requiring PA. Codes without a flag carry no published PA indicator.
Where do these rates come from?
Directly from Idaho's published Medicaid fee-for-service schedule (effective 2026), collected and normalized by ProviderSignal across all 50 states + DC. Rates are re-collected on a rolling schedule and this page updates automatically. Procedure descriptions are ProviderSignal's own plain-language labels or public-domain CMS text.
Get an email the next time Idaho changes these rates.