Q9982 Medicaid reimbursement rate by state (2026)
Flutemetamol f18, diagnostic, per study dose. Medicaid pays a median of $3,342.24 for Q9982 across 7 states, from $2,826.66 in New Hampshire to $28,248.00 in Ohio.
- States publishing
- 7
- National median
- $3,342.24units vary by state
- Lowest
- $2,826.66New Hampshire
- Highest
- $28,248.00Ohio
What does Medicaid pay for Q9982?
7 state Medicaid programs publish a fee-for-service rate for Q9982. The national median is $3,342.24 (units differ between states). Ohio pays the most, $28,248.00, and New Hampshire the least, $2,826.66, a 10.0x spread.
Q9982 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 7 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 Q9982, 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. 3 of the 7 states list more than one rate for Q9982, 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. None of the 7 schedules prints a separate unit for Q9982, so each amount is a flat payment for one service as the code defines it.
- Per hour. Q9982 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 Q9982, 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 Q9982 rates differ between states
Published rates for Q9982 run from $2,826.66 in New Hampshire to $28,248.00 in Ohio, a 10.0x gap in the same unit. Half the states pay more than the median of $3,342.24 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. 5 states set the current rate for Q9982 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.
What managed-care plans pay for Q9982
Most Medicaid members are in managed-care plans, and plans don't publish their provider fee schedules. For Q9982, the public signal is the rule each state sets for its plans, recorded on each rate above.
In 1 state, the published rate binds plans: a floor, a pass-through or a state-set rate. In 4 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 2 states is not classified yet.
- Plans negotiate; the published rate applies out of network (4 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 (1 state). 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 Ohio managed care.
Units and billing for Q9982
Q9982 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.
Drug codes are billed in units of the dose stated in the code, so a larger dose bills more units. Many states require the National Drug Code (NDC) on the claim alongside the billing code.
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 Q9982?
It depends on the state. Of the 7 states with a published fee-for-service rate, the median is $3,342.24. Ohio pays the most ($28,248.00) and New Hampshire the least ($2,826.66).
Which state pays the highest Medicaid rate for Q9982?
Ohio, at $28,248.00, effective 2016-07-01.
Which state pays the lowest Medicaid rate for Q9982?
New Hampshire, at $2,826.66, effective 2026-07-01.
What unit is Q9982 billed in?
None of the 7 schedules prints a separate unit for Q9982, so each amount is a flat payment for one service as the code defines it.
Do managed-care plans pay the same rate for Q9982?
Not necessarily. In 1 state, the published rate binds plans: a floor, a pass-through or a state-set rate. In 4 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 2 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.