J9314 HCPCS code: Injection, pemetrexed (teva), not therapeutically equivalent to j9305, 10 mg
J9314 is the HCPCS Level II code for injection, pemetrexed (teva), not therapeutically equivalent to j9305, 10 mg. In 2024 Medicare paid an average of $10.08 per service for J9314 across 3,345 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 rose 99% from 2023 to 2024 (1,677 to 3,345 services). In 2024, about 14 clinicians billed Medicare for J9314 for 16 beneficiaries.
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 | O1D — Chemotherapy |
| Added | 2023-01-01 |
| Last action effective | 2024-07-01 |
Who bills J9314 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 14 |
| Medicare beneficiaries | 16 |
| States with claims | 0 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J9314, 2023–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2023 | 1,677 | 14 | $19.57 | $15.60 |
| 2024 | 3,345 | 16 | $12.65 | $10.08 |
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 J9314
- 2023-01-01: J9314 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 J9314?
J9314 is the HCPCS Level II code for injection, pemetrexed (teva), not therapeutically equivalent to j9305, 10 mg. Short descriptor: "Inj pemetrexed (teva) 10mg".
How much does Medicare pay for J9314?
In 2024, the average Medicare payment was $10.08 per service (average allowed $12.65).
Does Medicare cover J9314?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J9314 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
- J9305 — Injection, pemetrexed, not otherwise specified, 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
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 J9314
- Watch J9314 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J9314
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.