The Rates plan
$29/mo7-day free trialThe table on this page is a common-procedure sample. The full Illinois drugs schedule has 782 codes.
- Every code on all 51 published schedules
- Full-schedule CSV export
- Full state Medicaid dental network lists
- Email alerts when a state changes its rates
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Published codes
782
Drugs procedures on the 2026 schedule
Median % of Medicare
--
no national Medicare comparator for this category
Effective vintage
2026
latest effective year on the schedule
Common drugs procedures and what Illinois Medicaid pays
A curated sample of recognizable procedures from the 782-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 | Illinois rate | % of Medicare |
|---|---|---|---|
| J0696 | Injection, ceftriaxone sodium, per 250 mg | $0.42 | -- |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | $0.11 | -- |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | $0.33 | -- |
| J2550 | Injection, promethazine hcl, up to 50 mg | $3.25 | -- |
| J3420 | Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg | $0.65 | -- |
| 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 Illinois Medicaid fee schedules
- Illinois physician fee schedule · 6,469 codes
- Illinois lab & imaging fee schedule · 2,095 codes
- Illinois dme & supplies fee schedule · 1,563 codes
- Illinois other services fee schedule · 185 codes
- Illinois vision fee schedule · 82 codes
- Illinois hearing fee schedule · 45 codes
Drugs rates in neighboring states
Frequently asked questions
What does Illinois Medicaid pay for physician-administered drugs?
Illinois Medicaid publishes 782 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 Illinois'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 Illinois?
Illinois does not publish prior-authorization indicators on this fee schedule, so PA requirements must be confirmed through the state's provider manual or portal. Absence of a flag here means "not published", never "no PA required".
Where do these rates come from?
Directly from Illinois'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 Illinois changes these rates.