HCPCS Code Details - J9304

HCPCS Level II Code
Drugs administered other than oral method, chemotherapy drugs
HCPCS Code J9304
Description

Long description:
Injection, pemetrexed (pemfexy), 10 mg

Short description:
Inj. pemetrexed, 10 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
BETOS2 code O1E - Other drugs
HCPCS Action code N - No maintenance for this code
Type of service 1 - Medical care
Effective date Effective Oct 01, 2020
Date added Added Oct 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 - J9304

Effective Code Dosage Payment
Limit
Vaccine AWP % Vaccine Limit Infusion AWP % DME infusion limit Blood AWP % Blood limit Clotting factor Note
April 1, 2024 - June 30, 2024 10 MG 63.078 - - - - - -
January 1, 2024 - March 31, 2024 10 MG 62.318 - - - - - -
October 1, 2023 - December 31, 2023 10 MG 66.23 20% - - - - -
Jul 1, 2023 - Sep 30, 2023 10 MG 64.476 20% - - - - -
April 1, 2023 - June 30, 2023 10 MG 77.551 20% - - - - -

See also

  • HCPCS J9303 · Injection, panitumumab, 10 mg

  • HCPCS J9305 · Injection, pemetrexed, not otherwise specified, 10 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”