Q2009 Medicaid reimbursement rate by state (2026)
Injection, fosphenytoin, 50 mg phenytoin equivalent. Medicaid pays a median of $1.53 for Q2009 across 25 states, from $0.45 in Maryland to $10.19 in New Jersey.
- States publishing
- 25
- National median
- $1.53units vary by state
- Lowest
- $0.45Maryland
- Highest
- $10.19New Jersey
What does Medicaid pay for Q2009?
25 state Medicaid programs publish a fee-for-service rate for Q2009. The national median is $1.53 (units differ between states). New Jersey pays the most, $10.19, and Maryland the least, $0.45, a 22.6x spread.
Q2009 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 25 states with every variant, modifier and effective date.
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 Q2009, 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. 7 of the 25 states list more than one rate for Q2009, 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 25 states, 1 publish Q2009 per unit, and 24 schedules print no unit at all (a flat amount per service).
- Per hour. Q2009 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 Q2009, 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.
Why Q2009 rates differ between states
Published rates for Q2009 run from $0.45 in Maryland to $10.19 in New Jersey, a 22.6x gap in the same unit. Half the states pay more than the median of $1.53 and half pay less. The usual reasons for a spread like this in physician & professional rates:
- Primary-care and pediatric add-ons, enhanced rates for certain specialties and targeted increases for access problems change individual codes without moving the rest of the schedule.
- Modifiers such as professional or technical component, bilateral, multiple procedure and assistant at surgery change the amount paid, and states apply them with their own percentages.
- Each state sets its own physician conversion factor or fee for every code, and many update them on a state budget cycle rather than on Medicare's calendar.
Timing matters too. 10 states set the current rate for Q2009 in 2026 or later, while 6 states 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.
What managed-care plans pay for Q2009
Most Medicaid members are in managed-care plans, and plans don't publish their provider fee schedules. For Q2009, 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 12 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 (12 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 New Jersey managed care.
Units and billing for Q2009
Q2009 is a HCPCS Level II temporary code in the physician & professional line, billed mostly by physicians, nurse practitioners, physician assistants and other licensed practitioners. Q codes are temporary codes for drugs, biologicals, supplies and services. The unit depends on the code and is often a dose or an item.
Physician-fee-schedule codes are billed per service: one unit is one occurrence unless the code itself is defined by time or quantity. Practitioners who are not physicians are often paid a reduced percentage of the published amount, so check the schedule for the reduction that applies to your provider type.
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.
Frequently asked questions
What does Medicaid pay for Q2009?
It depends on the state. Of the 25 states with a published fee-for-service rate, the median is $1.53. New Jersey pays the most ($10.19) and Maryland the least ($0.45).
Which state pays the highest Medicaid rate for Q2009?
New Jersey, at $10.19, effective 2025-01-01.
Which state pays the lowest Medicaid rate for Q2009?
Maryland, at $0.45, effective 2026-01-01.
What unit is Q2009 billed in?
Of the 25 states, 1 publish Q2009 per unit, and 24 schedules print no unit at all (a flat amount per service).
Do managed-care plans pay the same rate for Q2009?
Not necessarily. In 4 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 12 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.