New Jersey Medicaid rate for CPT 11042
NJ FamilyCare pays a median of $64.66 across its rate types for CPT 11042 in its July 2026 fee-for-service schedule: the 14th-lowest of 45 state Medicaid programs, at 66% of the $98.39 median.
- Non-facility rate
- $64.66
- Rank
- 32 of 45
- vs. state median
- 66%
- vs. NJ Medicare
- 43-45%
What NJ FamilyCare publishes for 11042
14th-lowest of 45 · 66% of median
- Schedule
- July 2026
- In effect since
- Jul 1, 2026
$57.78 to $72.16 across 4 rate types
- Children Specialist or Purchase
- $72.16
- Fee Specialist or Purchase
- $67.98
- Children Non Specialist or Rental
- $61.34
- Fee Non Specialist or Rental
- $57.78
Unmodified non-facility fee-for-service rate from the state's published file. Managed-care contracts, supplemental payments, and claim-specific adjustments can change what is paid. NJMMIS Procedure Master
11042 in neighboring states
Each state's comparable non-facility rate for 11042 in its current schedule.
| State | Rate | vs. New Jersey |
|---|---|---|
| Delaware | $128.88 | +99% |
| Pennsylvania | $33.00 | -49% |
11042 in every state
Map and ranking of every state program that prices 11042.
Compare 11042 across states11042 under Medicare
Medicare's 2026 non-facility payment for 11042 in New Jersey is $143.12 to $150.24 across its 2 payment localities; NJ FamilyCare's rate is 43-45% of that. The national amount before geographic adjustment is $132.602.
See 11042 Medicare ratesSee New Jersey's full schedule: all 12,793 codes, every published period, and commercial payer rates for 11042.
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