The Rates plan
$29/mo7-day free trialThe table on this page is a common-procedure sample. The full Montana drugs schedule has 895 codes.
- Every code on all 51 published schedules
- Full-schedule CSV export
- Full state Medicaid dental network lists
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Published codes
895
Drugs procedures on the 2026 schedule
Median % of Medicare
--
no national Medicare comparator for this category
PA required
32
codes flagged by the state
Common drugs procedures and what Montana Medicaid pays
A curated sample of recognizable procedures from the 895-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 | Montana rate | % of Medicare |
|---|---|---|---|
| J0696 | Injection, ceftriaxone sodium, per 250 mg | $0.46 | -- |
| 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 | $3.97 | -- |
| J3420 | Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg | $0.64 | -- |
| J7030 | Infusion, normal saline solution , 1000 cc | $1.99 | -- |
| 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 Montana Medicaid fee schedules
- Montana physician fee schedule · 7,001 codes
- Montana lab & imaging fee schedule · 2,711 codes
- Montana dme & supplies fee schedule · 1,843 codes
- Montana other services fee schedule · 726 codes
- Montana anesthesia fee schedule · 275 codes
- Montana vision fee schedule · 145 codes
Drugs rates in neighboring states
Frequently asked questions
What does Montana Medicaid pay for physician-administered drugs?
Montana Medicaid publishes 895 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 Montana'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 Montana?
Montana publishes prior-authorization flags on its schedule: 32 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 Montana'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 Montana changes these rates.