J9292 HCPCS code: Injection, pemetrexed dipotassium, 10 mg
J9292 is the HCPCS Level II code for injection, pemetrexed dipotassium, 10 mg. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 150 per day on DME suppliers.
Code details
| Field | Value |
|---|---|
| Section | J codes — Drugs administered other than oral method |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 51 — Drug or biological (priced per ASP/average sales price rules) |
| BETOS category | O1E — Other drugs |
| Added | 2025-01-01 |
| Last action effective | 2025-07-01 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 150 | Prescribing Information |
| outpatient hospital claims | 150 | Prescribing Information |
| practitioner claims | 150 | Prescribing Information |
What changed for J9292
- July 2025: Descriptor revised (Was: Injection, pemetrexed (avyxa), not therapeutically equivalent to j9305, 10 mg)
- 2025-01-01: J9292 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 J9292?
J9292 is the HCPCS Level II code for injection, pemetrexed dipotassium, 10 mg. Short descriptor: "Inj, pemetrexed dipotassium".
Does Medicare cover J9292?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J9292 can be billed per day?
150 on DME suppliers; 150 on outpatient hospital claims; 150 on practitioner claims (NCCI medically unlikely edits).
Related J92 codes
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Next steps
- Run a reimbursement report for a device billed under J9292
- Watch J9292 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J9292
Sources: CMS HCPCS Level II release October 2026; 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.