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Billing code Q2041 · Pharmacy

Q2041 Medicaid reimbursement rate by state (2026)

Axicabtagene ciloleucel. Medicaid pays a median of $555,700.45 for Q2041 across 18 states, from $5,625.01 in South Carolina to $577,943.26 in Georgia.

Data as of Oct 5, 202618 statesEvery rate links to its official source

States publishing
18
National median
$555,700.45units vary by state
Lowest
$5,625.01South Carolina
Highest
$577,943.26Georgia
Answer

What does Medicaid pay for Q2041?

18 state Medicaid programs publish a fee-for-service rate for Q2041. The national median is $555,700.45 (units differ between states). Georgia pays the most, $577,943.26, and South Carolina the least, $5,625.01, a 102.7x spread.

State ranking

Q2041 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 18 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Georgia Source · since 2026-10-01$577,943.26——Plans negotiate; applies out of network—
2Ohio Source · since 2026-10-01$577,943.26——Plans negotiate; applies out of network—
3Kansas Source · since 2026-10-01$577,943.26——Plans must pay at least this—
9Nevada Source · since 2026-09-01$562,500.89——Plans must pay at least this—
10New Hampshire Source · since 2026-07-01$548,900.00——Plans negotiate; applies out of network—
11Montana Source · since 2025-10-01$532,192.24——Not classified—
17California Source · since 2026-07-01$93,750.15——Plans negotiate; applies out of network—
18South Carolina Source · since 2026-07-01$5,625.01——Not classified—
See all 18 states for Q2041 — start free

10 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.

  • Source for every rate
  • Full rate history
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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 Q2041 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 Q2041, 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. 5 of the 18 states list more than one rate for Q2041, 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 18 states, 1 publish Q2041 per up to 200 million car t cells and 1 per unit, and 16 schedules print no unit at all (a flat amount per service).
  • Per hour. Q2041 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 Q2041, 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 Q2041 rates differ between states

Published rates for Q2041 run from $5,625.01 in South Carolina to $577,943.26 in Georgia, a 102.7x gap in the same unit. Half the states pay more than the median of $555,700.45 and half pay less. The usual reasons for a spread like this in pharmacy rates:

  • 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.
  • 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.

Timing matters too. 15 states set the current rate for Q2041 in 2026 or later. 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 Q2041

Most Medicaid members are in managed-care plans, and plans don't publish their provider fee schedules. For Q2041, the public signal is the rule each state sets for its plans, recorded on each rate above.

In 2 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 10 states, plans negotiate and the published rate is a benchmark or out-of-network default. In 1 state, the service is paid outside the plans or through a state-directed payment. The rule for the remaining 5 states is not classified yet.

  • Plans negotiate; the published rate applies out of network (10 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 (2 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.
  • Paid by the state, outside the plans (1 state). Bill the state's Medicaid program, not the plan, at the published rate. There is no plan contract to negotiate for this service.

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 Georgia managed care.

Billing

Units and billing for Q2041

Q2041 is a HCPCS Level II temporary code in the pharmacy line, billed mostly by practices and clinics that administer vaccines and drugs. 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.

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 Q2041?

It depends on the state. Of the 18 states with a published fee-for-service rate, the median is $555,700.45. Georgia pays the most ($577,943.26) and South Carolina the least ($5,625.01).

Which state pays the highest Medicaid rate for Q2041?

Georgia, at $577,943.26, effective 2026-10-01.

Which state pays the lowest Medicaid rate for Q2041?

South Carolina, at $5,625.01, effective 2026-07-01.

What unit is Q2041 billed in?

Of the 18 states, 1 publish Q2041 per up to 200 million car t cells and 1 per unit, and 16 schedules print no unit at all (a flat amount per service).

Do managed-care plans pay the same rate for Q2041?

Not necessarily. In 2 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 10 states, plans negotiate and the published rate is a benchmark or out-of-network default. In 1 state, the service is paid outside the plans or through a state-directed payment. The rule for the remaining 5 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.