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Billing code J7297 · Pharmacy

J7297 Medicaid reimbursement rate by state (2026)

Levonorgestrel-releasing intrauterine contraceptive system. Medicaid pays a median of $978.32 for J7297 across 41 states, from $47.97 in Delaware to $1,097.90 in New Mexico.

Data as of Oct 5, 202641 statesEvery rate links to its official source

States publishing
41
National median
$978.32units vary by state
Lowest
$47.97Delaware
Highest
$1,097.90New Mexico
Answer

What does Medicaid pay for J7297?

41 state Medicaid programs publish a fee-for-service rate for J7297. The national median is $978.32 (units differ between states). New Mexico pays the most, $1,097.90, and Delaware the least, $47.97, a 22.9x spread.

State ranking

J7297 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 41 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1New Mexico Source · since 2025-01-01$1,097.90——Plans must pay at least this—
2South Carolina Source · since 2026-04-01$1,074.90——Not classified—
3Nevada Source · since 2026-06-01$1,074.90——Plans must pay at least this—
20Kansas Source · since 2026-01-02$978.32——Plans must pay at least this—
21Mississippi Source · since 2026-07-01$978.32——Plans must pay at least this—
22New Hampshire Source · since 2026-07-01$978.32——Plans negotiate; applies out of network—
40Connecticut Source · since 2020-03-01$100.00——Not classified—
41Delaware Source · since 2024-01-01$47.97——Plans negotiate; applies out of network—
See all 41 states for J7297 — start free

33 more states, with every modifier and provider-type variant, rate history and the plan rule in each state. 14-day free trial, no credit card.

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Rates are per the unit shown for each state; units can differ between states. Medicare amounts are computed from the CMS relative value file and locality cost indices; states with several Medicare localities show a range. Confirm rates with the payer before billing.

Track J7297 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
FAQ

Frequently asked questions

What does Medicaid pay for J7297?

It depends on the state. Of the 41 states with a published fee-for-service rate, the median is $978.32. New Mexico pays the most ($1,097.90) and Delaware the least ($47.97).

Which state pays the highest Medicaid rate for J7297?

New Mexico, at $1,097.90, effective 2025-01-01.

Do managed-care plans pay the same rate for J7297?

Not necessarily. Each state's plan contracts decide whether plans must pay at least the fee-for-service rate, pay a state-set rate, or negotiate their own. The workspace shows the rule for each state, cited to the contract or statute.