HCPCS Code Details - J9198

HCPCS Level II Code
Drugs administered other than oral method, chemotherapy drugs
HCPCS Code J9198
Description

Long description:
Injection, gemcitabine hydrochloride, (infugem), 100 mg

Short description:
Inj. infugem, 100 mg

HCPCS Modifier1
HCPCS Pricing indicator 51 - Drugs
Multiple pricing indicator A - Not applicable as HCPCS priced under one methodology
Coverage code C - Carrier judgment
ASC payment group code Effective Jan 01, 2021 - This procedure is approved to be performed in an ambulatory surgical center.
BETOS2 code O1D - Chemotherapy
HCPCS Action code N - No maintenance for this code
Type of service 1 - Medical care
Effective date Effective Jan 01, 2021
Date added Added Jul 01, 2020
HCPCS Coding Procedures

HCPCS Modifiers

In HCPCS Level II, modifiers are composed of two alpha or alphanumeric characters.

Example: E0260-NU - Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress
NU” identifies the hospital bed as new equipment

ASP Drug pricing - J9198

Effective Code Dosage Payment
Limit
Vaccine AWP % Vaccine Limit Infusion AWP % DME infusion limit Blood AWP % Blood limit Clotting factor Note
January 1, 2024 - March 31, 2024 100 MG 40.28 - - - - - -
October 1, 2023 - December 31, 2023 100 MG 40.28 19.6686706427487% - - - - -
Jul 1, 2023 - Sep 30, 2023 100 MG 40.28 19.397% - - - - -
April 1, 2023 - June 30, 2023 100 MG 24.667 20% - - - - -
100 MG 27.29 - - - - - -

See also

  • HCPCS J9196 · Injection, gemcitabine hydrochloride (accord), not therapeutically equivalent to j9201, 200 mg

  • HCPCS J9201 · Injection, gemcitabine hydrochloride, not otherwise specified, 200 mg

  • HCPCS J9199 · Injection, gemcitabine hydrochloride (infugem), 200 mg


1 Two-digit numeric codes are Level I code modifiers copyrighted© by the American Medical Association's Current Procedural Terminology (CPT).

2 BETOS stands for “Berenson-Eggers Type Of Service”