J8670 HCPCS code: Rolapitant, oral, 1 mg
J8670 is the HCPCS Level II code for rolapitant, oral, 1 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 180 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 | O1E — Other drugs |
| Added | 2017-01-01 |
| Last action effective | 2017-01-01 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 180 | CMS Policy |
| outpatient hospital claims | 180 | Prescribing Information |
Medicare policy articles for this code
- A52480: Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
Covered diagnoses (1,280 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| C00.0 | Malignant neoplasm of external upper lip | 1 |
| C00.1 | Malignant neoplasm of external lower lip | 1 |
| C00.3 | Malignant neoplasm of upper lip, inner aspect | 1 |
| C00.4 | Malignant neoplasm of lower lip, inner aspect | 1 |
| C00.6 | Malignant neoplasm of commissure of lip, unspecified | 1 |
| C00.8 | Malignant neoplasm of overlapping sites of lip | 1 |
| C01 | Malignant neoplasm of base of tongue | 1 |
| C02.0 | Malignant neoplasm of dorsal surface of tongue | 1 |
| C02.1 | Malignant neoplasm of border of tongue | 1 |
| C02.2 | Malignant neoplasm of ventral surface of tongue | 1 |
Showing 10 of 1,280. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for J8670
- 2017-01-01: J8670 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 J8670?
J8670 is the HCPCS Level II code for rolapitant, oral, 1 mg. Short descriptor: "Rolapitant, oral, 1mg".
Does Medicare cover J8670?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Which diagnoses support coverage for J8670?
Medicare policy articles that cite J8670 list 1,280 covered ICD-10-CM diagnosis codes across 1 article. The most cited include C00.0 (Malignant neoplasm of external upper lip), C00.1 (Malignant neoplasm of external lower lip), C00.3 (Malignant neoplasm of upper lip, inner aspect). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
How many units of J8670 can be billed per day?
180 on DME suppliers; 180 on outpatient hospital claims (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
- J8612 — Methotrexate (xatmep), oral, 2.5 mg
- J8650 — Nabilone, oral, 1 mg
- J8655 — Netupitant 300 mg and palonosetron 0.5 mg, oral
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under J8670
- Watch J8670 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J8670
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.