State programs

States M2 J-code book: Medicaid J-code rates vs Medicare ASP (vw_state_medicaid_jcode_vs_asp_v1)

vlada_curated.vw_state_medicaid_jcode_vs_asp_v1·partial·semantic_view

Rows

N/A

Columns

History

N/A

Card

nocolumns only

Typed tools

What it is

1Medicaid physician-administered drug rates (HCPCS J-codes) as each state prints them, beside Medicare's ASP payment limit (ASP + 6%) for the same code and billing unit (hcpcs_dosage). implied_asp_plus = rate / (limit / 1.06) - 1, so 0.06 means the state pays ASP + 6%.
2Two readings: _at_eff (the ASP quarter the rate took effect, how the state priced it) and _current (today's ASP quarter).
3A printed $0 / NDC-required / by-report line is never here.

Grain

Key	Grain
N/A	1One row per in-force priced HCPCS J-code rate (state x schedule x code x modifiers x program x provider type x setting), beside the Medicare ASP payment limit for the same code in the current quarter and in the quarter the rate took effect. 279,302 rows, 44 states (Athena, 2026-11-05).

Columns (28)

Column	Type	Meaning
`state`	string
`schedule_id`	string
`service_line`	string
`code`	string
`modifiers`	string
`program`	string
`provider_type`	string
`setting`	string
`geography`	string
`population`	string
`rate_type`	string
`rate_unit`	string
`rate`	double
`eff`	date
`edition_effective_date`	date
`description`	string
`source_sha256`	string
`source_ref`	string
`asp_quarter_current`	string
`asp_limit_current`	double
`hcpcs_dosage`	string
`ratio_to_medicare_current`	double
`implied_asp_plus_current`	double
`asp_quarter_at_eff`	string
`asp_limit_at_eff`	double
`ratio_to_medicare_at_eff`	double
`implied_asp_plus_at_eff`	double
`unit_mismatch_suspect`	boolean

Query it

describe_data_source(source_fqn="vlada_curated.vw_state_medicaid_jcode_vs_asp_v1")     # the card, live
query_substrate(sql="SELECT * FROM vlada_curated.vw_state_medicaid_jcode_vs_asp_v1 WHERE <filter> LIMIT 100")

Item	Value
Typed tools that read it	none; raw SQL
Identity key	N/A
Join	`how_to_join(source_fqn="vlada_curated.vw_state_medicaid_jcode_vs_asp_v1")`
Raw door	Athena (read-only via query_substrate): vlada_curated.vw_state_medicaid_jcode_vs_asp_v1 (filter state (and code) before reading; read provider_type and setting on every row)

This page as markdown: /docs-md/data/vlada_curated_vw_state_medicaid_jcode_vs_asp_v1.md · every page in one file: /llms-full.txt