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See a sample rate comparisonHCPCS J1200 (Diphenhydramine Hcl) Fee Schedule
Last Verified: October 2026
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, diphenhydramine HCl, up to 50 mg
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Drugs, Administered by Injection |
| Common Place of Service | None 11 - Office |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J1200 |
| Medicare Payment Limit | $0.755  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 00641-0376-21 - DIPHENHYDRAMINE HCL (DOSETTE VIAL) 50 MG/ML • 00641-6282-25 - DIPHENHYDRAMINE HCL NOVAPLUS HIGH POTENCY;25X1ML 50 MG/1 ML • 23155-0264-41 - DIPHENHYDRAMINE HCL 50 MG/1 ML • 25021-0481-01 - DIPHENHYDRAMINE HCL 50 MG/1 ML • 38779-0282-04 - DIPHENHYDRAMINE HCL (U.S.P.) |
National average reimbursement for HCPCS J1200 by major payers:
$0.85
$0.88
$0.98
$0.83
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HCPCS J1200
5 of 25 sample ratesHigher to lower in this preview
Beau Ellenbecker
Healthtexas Provider Network
$3.65Published rateJoshua Reinhart
Timberland Medical Group
$1.18Published rateJoseph Deblasio
Hamilton Medical Group PC
$1.00Published rateAlyson Emmons
Life Choice Hospice Of New Jersey LLC
$0.81Published rateMartin Pontecorvo
Barnabas Health Medical Group P C
$0.66Published rate
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See a sample payer proposalHCPCS J1200 vs. Other Drugs, Administered by Injection Codes
The HCPCS J1200 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 J1200 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.
| Code | Complexity | Description |
|---|---|---|
| 00641-0376-21-NDC | Moderate | DIPHENHYDRAMINE HCL (DOSETTE VIAL) 50 MG/ML |
| 00641-6282-25-NDC | Moderate | DIPHENHYDRAMINE HCL NOVAPLUS HIGH POTENCY;25X1ML 50 MG/1 ML |
| 23155-0264-41-NDC | Moderate | DIPHENHYDRAMINE HCL 50 MG/1 ML |
| J1200-HCPCS | Low | Injection, diphenhydramine HCl, up to 50 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J1200. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J1200 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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