J8612 HCPCS code: Methotrexate (xatmep), oral, 2.5 mg
J8612 is the HCPCS Level II code for methotrexate (xatmep), oral, 2.5 mg. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. The NCCI unit limit is 36 per day on DME suppliers.
Code details
| Field | Value |
|---|---|
| Section | J codes — Drugs administered other than oral method |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 51 — Drug or biological (priced per ASP/average sales price rules) |
| BETOS category | O1D — Chemotherapy |
| Added | 2024-07-01 |
| Last action effective | 2024-07-01 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 36 | Prescribing Information |
What changed for J8612
- 2024-07-01: J8612 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code J8612?
J8612 is the HCPCS Level II code for methotrexate (xatmep), oral, 2.5 mg. Short descriptor: "Oral methotrexate (xatmep)".
Does Medicare cover J8612?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of J8612 can be billed per day?
36 on DME suppliers (NCCI medically unlikely edits).
Related J86 codes
- J8600 — Melphalan; oral, 2 mg
- J8610 — Methotrexate; oral, 2.5 mg
- J8611 — Methotrexate (jylamvo), oral, 2.5 mg
- J8650 — Nabilone, oral, 1 mg
- J8655 — Netupitant 300 mg and palonosetron 0.5 mg, oral
- J8670 — Rolapitant, oral, 1 mg
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Next steps
- Run a reimbursement report for a device billed under J8612
- Watch J8612 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J8612
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.