HCPCS Code Details - J9260

HCPCS Level II Code
Drugs administered other than oral method, chemotherapy drugs
HCPCS Code J9260
Description

Long description:
Injection, methotrexate sodium, 50 mg

Short description:
Inj methotrexate sodium 50mg

HCPCS Modifier1
HCPCS Pricing indicator 51 - Drugs
Multiple pricing indicator A - Not applicable as HCPCS priced under one methodology
Coverage code D - Special coverage instructions apply
BETOS2 code O1D - Chemotherapy
HCPCS Action code N - No maintenance for this code
Type of service 1 - Medical care
Effective date Effective Apr 01, 2024
Date added Added Jan 01, 1984
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 - J9260

Effective Code Dosage Payment
Limit
Vaccine AWP % Vaccine Limit Infusion AWP % DME infusion limit Blood AWP % Blood limit Clotting factor Note
October 1, 2024 - December 31, 2024 50 MG 2.723 - - - - - -
Jul 1, 2024 - Sep 30, 2024 50 MG 2.581 - - - - - -
April 1, 2024 - June 30, 2024 50 MG 2.572 - - - - - -
January 1, 2024 - March 31, 2024 50 MG 3.033 - - - - - -
October 1, 2023 - December 31, 2023 50 MG 2.325 20% - - - - -

See also

  • HCPCS J9259 · Injection, paclitaxel protein-bound particles (american regent), not therapeutically equivalent to j9264, 1 mg

  • HCPCS J9261 · Injection, nelarabine, 50 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”