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HCPCS J0120 (Tetracycline Hcl) Fee Schedule

Last Verified: November 2025

Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.

Injection, tetracycline, up to 250 mg
Key FactDetail
Service Type

Drugs Administered Other than Oral Method

Drugs, Administered by Injection

Common Place of Service

11 - Office

None

71 - Public Health Clinic

Complexity LevelLow
WAC Price
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National average reimbursement for HCPCS J0120 by major payers:

bcbs

$65.19

uhc

$9.80

aetna

$15.00

cigna

$11.47

Preview provider-level rates for...
For billing codeHCPCS J0120
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for HCPCS J0120

United
J0120$55.001720019995 - NORTH SHORE MEDICAL CENTER, INC., NORTH SHORE MEDICAL CENTER752922710FLGeneral Acute Care Hospital (282N00000X)
United
J0120$6.191548750417 - UKHS GREAT BEND, LLC, THE UNIVERSITY OF KANSAS HEALTH SYSTEM GREAT BEND CAMPUS830516935KSGeneral Acute Care Hospital (282N00000X)
United
J0120$35.001871540237 - VARIETY CHILDREN'S HOSPITAL, NICKLAUS CHILDREN'S HOSPITAL590638499 - (FL) VARIETY CHILDRENS HOSPITALFLGeneral Acute Care Hospital (282N00000X)
United
J0120$7.281306849708 - BRATTLEBORO MEMORIAL HOSPITAL, BRATTLEBORO MEMORIAL HOSPITAL30107300 - (VT) BRATTLEBORO MEMORIAL HOSPITALVTGeneral Acute Care Hospital (282N00000X)
United
J0120$60.001720019995 - NORTH SHORE MEDICAL CENTER, INC., NORTH SHORE MEDICAL CENTER592635307 - (FL) NORTH SHORE MEDICAL CENTER INCFLGeneral Acute Care Hospital (282N00000X)
United
J0120$50.001205056371 - DAY KIMBALL HEALTHCARE, INC.60646599 - (CT) DAY KIMBALL HEALTHCARE INCCTGeneral Acute Care Hospital (282N00000X)
United
J0120$7.281427154335 - CATHOLIC MEDICAL CENTER20315693 - CATHOLIC MEDICAL CENTERNHGeneral Acute Care Hospital (282N00000X)
United
J0120$15.891043670334 - SUTTER BAY HOSPITALS, MILLS-PENINSULA MEDICAL CENTER940562680 - (CA) SUTTER BAY HOSPITALSCAGeneral Acute Care Hospital (282N00000X)
United
J0120$15.891760489223 - LAWTON INDIAN HOSPITAL, IHS HEALTH SERVICE820581689OKGeneral Acute Care Hospital (282N00000X)
United
J0120$55.001720019995 - NORTH SHORE MEDICAL CENTER, INC., NORTH SHORE MEDICAL CENTER752922687FLGeneral Acute Care Hospital (282N00000X)
United
J0120$15.891134123193 - ST. ANTHONY SHAWNEE HOSPITAL, INC., SSM HEALTH ST. ANTHONY HOSPITAL - SHAWNEE731347360 - (OK) AVEDIS FOUNDATIONOKGeneral Acute Care Hospital (282N00000X)
United
J0120$15.891093763781 - JACKSON COUNTY MEMORIAL HOSPITAL AUTHORITY, JACKSON CO MEM HOSP730568956OKGeneral Acute Care Hospital (282N00000X)
United
J0120$55.001720019995 - NORTH SHORE MEDICAL CENTER, INC., NORTH SHORE MEDICAL CENTER591223933FLGeneral Acute Care Hospital (282N00000X)
United
J0120$40.001306119730 - VARIETY CHILDREN'S HOSPITAL, NICKLAUS CHILDREN'S MIAMI LAKES OUTPATIENT CENTER590638499 - (FL) VARIETY CHILDRENS HOSPITALFLGeneral Acute Care Hospital (282N00000X)
United
J0120$6.551912334517 - FAUQUIER MEDICAL CENTER LLC, FAUQUIER HOSPITAL463107896VAGeneral Acute Care Hospital (282N00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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HCPCS J0120 vs. Other Drugs, Administered by Injection Codes

The HCPCS J0120 code is part of the Drugs Administered Other than Oral Method services used for Drugs, Administered by Injection. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The HCPCS J0120 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

CodeComplexityDescription
J0120-HCPCSLowInjection, tetracycline, up to 250 mg
J0121-HCPCSLowInjection, omadacycline, 1 mg

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J0120. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the J0120 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.

Factors that affect fee schedules


Medicare & Medicaid Rates

Government-set reimbursement amounts


Private Insurance Rates

Negotiated rates between providers and insurance companies


Geographic Location

Costs may be higher in urban areas.


Provider Type

Hospital providers may have different rates than private practice.

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