New Jersey Medicaid rate for CPT 12001
NJ FamilyCare pays a median of $69.05 across its rate types for CPT 12001 in its July 2026 fee-for-service schedule: the 12th-lowest of 45 state Medicaid programs, at 80% of the $86.45 median.
- Non-facility rate
- $69.05
- Rank
- 34 of 45
- vs. state median
- 80%
- vs. NJ Medicare
- 54-56%
What NJ FamilyCare publishes for 12001
12th-lowest of 45 · 80% of median
- Schedule
- July 2026
- In effect since
- Jul 1, 2026
$49.65 to $93.73 across 4 rate types
- Children Specialist or Purchase
- $93.73
- Children Non Specialist or Rental
- $79.67
- Fee Specialist or Purchase
- $58.42
- Fee Non Specialist or Rental
- $49.65
2 rate types
- Children Non Specialist or Rental and 1 more (SA)
- $75.69
- Fee Non Specialist or Rental and 1 more (SA)
- $49.65
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
12001 in neighboring states
Each state's comparable non-facility rate for 12001 in its current schedule.
| State | Rate | vs. New Jersey |
|---|---|---|
| Delaware | $110.53 | +60% |
| Pennsylvania | $24.50 | -65% |
12001 in every state
Map and ranking of every state program that prices 12001.
Compare 12001 across states12001 under Medicare
Medicare's 2026 non-facility payment for 12001 in New Jersey is $122.98 to $128.91 across its 2 payment localities; NJ FamilyCare's rate is 54-56% of that. The national amount before geographic adjustment is $113.897.
See 12001 Medicare ratesSee New Jersey's full schedule: all 12,793 codes, every published period, and commercial payer rates for 12001.
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