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Billing code J7332 · Pharmacy

J7332 Medicaid reimbursement rate by state (2026)

Hyaluronan or derivative, triluron. Medicaid pays a median of $10.23 for J7332 across 24 states, from $8.75 in Idaho to $27.87 in Arkansas.

Data as of Oct 5, 202624 statesEvery rate links to its official source

States publishing
24
National median
$10.23units vary by state
Lowest
$8.75Idaho
Highest
$27.87Arkansas
Answer

What does Medicaid pay for J7332?

24 state Medicaid programs publish a fee-for-service rate for J7332. The national median is $10.23 (units differ between states). Arkansas pays the most, $27.87, and Idaho the least, $8.75, a 3.2x spread.

State ranking

J7332 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 24 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Arkansas Source · since 2025-06-13$27.87——Not classified—
2New Jersey Source · since 2025-01-01$24.21——Not classified—
3Indiana Source · since 2025-10-01$13.13unit—Plans must pay at least this—
12Illinois Source · since 2026-04-01$10.26——Plans negotiate; applies out of network—
13Ohio Source · since 2026-10-01$10.19——Plans negotiate; applies out of network—
14Wisconsin Source · since 2026-10-01$10.19——Plans negotiate; applies out of network—
23Vermont Source · since 2026-01-01$9.76——Not classified—
24Idaho Source · since 2026-07-01$8.75——Not classified—
See all 24 states for J7332 — start free

16 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 J7332 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
Guide

How to read this table

  • Order. States are listed from the highest published rate to the lowest. No single unit is shared by 8 or more states for J7332, so the order is by published amount and is not a like-for-like rank.
  • Medicaid rate. The most the state's fee-for-service program pays for one unit, as published. 6 of the 24 states list more than one rate for J7332, by modifier, provider type or setting; the table shows the one that matches the provider level and setting used across states, without add-ons.
  • Unit. Of the 24 states, 1 publish J7332 per unit and 1 per 1 mg, and 22 schedules print no unit at all (a flat amount per service).
  • Per hour. J7332 is not billed in time units in these states, so no hourly figure is shown.
  • Managed-care plans. The rule the state sets for its plans on this rate. What each rule means is explained below.
  • % of Medicare. No Medicare physician fee schedule amount is on file for J7332, so there is no percentage.
  • Source and date. Each Source link opens the state's own document; “since” is the date the rate took effect.
Context

Why J7332 rates differ between states

Published rates for J7332 run from $8.75 in Idaho to $27.87 in Arkansas, a 3.2x gap in the same unit. Half the states pay more than the median of $10.23 and half pay less. The usual reasons for a spread like this in pharmacy rates:

  • For children, many vaccines are supplied through the federal Vaccines for Children program, so the Medicaid payment can be for administration only.
  • States differ in whether they pay a fixed fee, a percentage of a benchmark or invoice cost.
  • Drugs given in a practice or clinic are commonly priced from a benchmark such as average sales price or wholesale acquisition cost, which moves every quarter.

Timing matters too. 19 states set the current rate for J7332 in 2026 or later, while 1 state still pay a rate that took effect in 2022 or earlier. A state that has not updated its rate in years will drift down the ranking as others raise theirs.

Managed care

What managed-care plans pay for J7332

Most Medicaid members are in managed-care plans, and plans don't publish their provider fee schedules. For J7332, the public signal is the rule each state sets for its plans, recorded on each rate above.

In 4 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 11 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 9 states is not classified yet.

  • Plans negotiate; the published rate applies out of network (11 states). In-network rates can be above or below the published rate. The published rate is the benchmark both sides know, and the fallback if no contract is signed.
  • Plans must pay at least the published rate (4 states). The published rate is your floor. Negotiate up from it, and if a plan pays less, the contract provision is the basis for a payment dispute.

Plan-negotiated rates are never estimated here. To see the rule and its citation for a particular state, open that state's managed-care page, for example Arkansas managed care.

Billing

Units and billing for J7332

J7332 is a HCPCS Level II drug code in the pharmacy line, billed mostly by practices and clinics that administer vaccines and drugs. J codes cover drugs that are not self-administered. One unit is the dose stated in the code, so a claim for a larger dose bills several units.

Many states require the National Drug Code (NDC) on the claim alongside the billing code. Drug codes are billed in units of the dose stated in the code, so a larger dose bills more units.

Before billing, confirm the rate, unit and any modifier with the state's current schedule or the plan: the amounts here are as published, not a guarantee of payment.

FAQ

Frequently asked questions

What does Medicaid pay for J7332?

It depends on the state. Of the 24 states with a published fee-for-service rate, the median is $10.23. Arkansas pays the most ($27.87) and Idaho the least ($8.75).

Which state pays the highest Medicaid rate for J7332?

Arkansas, at $27.87, effective 2025-06-13.

Which state pays the lowest Medicaid rate for J7332?

Idaho, at $8.75, effective 2026-07-01.

What unit is J7332 billed in?

Of the 24 states, 1 publish J7332 per unit and 1 per 1 mg, and 22 schedules print no unit at all (a flat amount per service).

Do managed-care plans pay the same rate for J7332?

Not necessarily. In 4 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 11 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 9 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.