J9305 HCPCS code: Injection, pemetrexed, not otherwise specified, 10 mg
J9305 is the HCPCS Level II code for injection, pemetrexed, not otherwise specified, 10 mg. In 2024 Medicare paid an average of $3.50 per service for J9305 across 1,373,746 services. 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 outpatient hospital claims. Medicare volume fell 41% from 2022 to 2024 (2,335,875 to 1,373,746 services). In 2024, about 2,326 clinicians billed Medicare for J9305 for 3,599 beneficiaries; Texas, California, Florida accounted for 33% of services.
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 | 2005-01-01 |
| Last action effective | 2020-10-01 |
Who bills J9305 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 2,326 |
| Medicare beneficiaries | 3,599 |
| States with claims | 35 |
| Share of services in top 3 states (Texas, California, Florida) | 33% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J9305, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 2,335,875 | 6,017 | $67.75 | $54.13 |
| 2023 | 1,716,940 | 4,694 | $14.87 | $11.84 |
| 2024 | 1,373,746 | 3,599 | $4.40 | $3.50 |
States with the most J9305 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Texas | 192,282 | $3.49 |
| California | 141,326 | $3.49 |
| Florida | 104,470 | $3.50 |
| Arizona | 91,102 | $3.40 |
| Illinois | 88,363 | $3.53 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 150 | Prescribing Information |
| practitioner claims | 150 | Prescribing Information |
What changed for J9305
- 2005-01-01: J9305 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 J9305?
J9305 is the HCPCS Level II code for injection, pemetrexed, not otherwise specified, 10 mg. Short descriptor: "Inj. pemetrexed nos 10mg".
How much does Medicare pay for J9305?
In 2024, the average Medicare payment was $3.50 per service (average allowed $4.40).
Does Medicare cover J9305?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J9305 can be billed per day?
150 on outpatient hospital claims; 150 on practitioner claims (NCCI medically unlikely edits).
Related J93 codes
- J9300 — Injection, gemtuzumab ozogamicin, 5 mg
- J9301 — Injection, obinutuzumab, 10 mg
- J9302 — Injection, ofatumumab, 10 mg
- J9303 — Injection, panitumumab, 10 mg
- J9304 — Injection, pemetrexed (pemfexy), 10 mg
- J9306 — Injection, pertuzumab, 1 mg
- J9307 — Injection, pralatrexate, 1 mg
- J9308 — Injection, ramucirumab, 5 mg
- J9309 — Injection, polatuzumab vedotin-piiq, 1 mg
- J9310 — Injection, rituximab, 100 mg
- J9311 — Injection, rituximab 10 mg and hyaluronidase
- J9312 — Injection, rituximab, 10 mg
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 J9305
- Watch J9305 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J9305
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.