HCPCS J1568 (Octagam) Fee Schedule
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.
| 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 |
| Medicare Payment Limit | $47.525  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 00069-6002-02 - OCTAGAM 10% (PF,LATEX-FREE) 100 MG/1 ML • 00069-6111-02 - OCTAGAM 10% (PF,LATEX-FREE) 100 MG/1 ML • 00069-6339-02 - OCTAGAM 10% (PF,LATEX-FREE) 100 MG/1 ML • 00069-6550-02 - OCTAGAM 10% (PF,LATEX-FREE) 100 MG/1 ML • 00069-8400-02 - OCTAGAM 5% (SD,PF,LATEX-FREE) 50 MG/1 ML |
National average reimbursement for HCPCS J1568 by major payers:
$55.31
$54.25
$55.94
$52.80
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for HCPCS J1568 | ||||||
United | J1568 | $44.79 | 1881686392 - RUSSELL PACKARD | 262477205 - (TX) TEXAS SPECIALTY PHYSICIANS | TX | Psychiatry Physician (2084P0800X) |
United | J1568 | $50.38 | 1962542225 - MARIANA VARGA | 461326940 - (TX) GEORGETA VARGA MD PARKINSON DISEASE MOVEMENT DISORDERS CLINIC PLLC | TX | Neurology Physician (2084N0400X) |
United | J1568 | $46.97 | 1649706474 - WILLIAM JACKSON | 111871039 - (NY) ST CHARLES HOSPITAL CORP | TX | Neurology Physician (2084N0400X) |
United | J1568 | $44.79 | 1215972997 - PARVEEN ATHAR | 640801257 - (MS) RUTH K FREDERICKS MD | TX | Clinical Neurophysiology Physician (2084N0600X) |
United | J1568 | $55.15 | 1568480689 - ANWARUL HAQ | 561398929 | TX | Neurology Physician (2084N0400X) |
United | J1568 | $35.83 | 1629175625 - JORGE SARAVIA | 742221469 - (TX) JORGE A SARAVIA MD PA | TX | Neurology Physician (2084N0400X) |
United | J1568 | $49.29 | 1083816599 - MICHAEL RUBIN | 756002868 | TX | Neurocritical Care Physician (2084A2900X) |
United | J1568 | $46.84 | 1629265558 - DALLAS NEUROSCIENCE, P.A. | 260373971 - (TX) DALLAS NEUROSCIENCE PA | TX | Neurology Physician (2084N0400X) |
United | J1568 | $52.61 | 1932660750 - CARLOS DE LA GARZA | 270393637 - (TX) NORTH TEXAS STROKE CENTER PLLC | TX | Neurology Physician (2084N0400X) |
United | J1568 | $55.99 | 1316045008 - JOHN DE GROOT | 943281660 | TX | Neurology Physician (2084N0400X) |
United | J1568 | $44.11 | 1407172521 - ANDREW WONG | 821833804 - (TX) SYNAPTOVEDA PA | TX | Neurology Physician (2084N0400X) |
United | J1568 | $94.90 | 1538320908 - DANIJELA LEVACIC | 742958277 - SCOTT & WHITE CLINIC | TX | Neurology Physician (2084N0400X) |
United | J1568 | $49.00 | 1417447228 - DAVID BABITT | 384109786 - (TX) UT PHYSICIANS | TX | Sports Medicine (Psychiatry & Neurology) Physician (2084S0010X) |
United | J1568 | $56.54 | 1053447250 - KENNETH VANOWEN | 760385980 - MHS PHYSICIANS OF TEXAS | TX | Neurology Physician (2084N0400X) |
United | J1568 | $49.00 | 1679774152 - ASIF CHAUDHRY | 273728705 - ASIF CHAUDHRY MD PLLC SPINE AND PAIN | TX | Pain Medicine (Psychiatry & Neurology) Physician (2084P2900X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
HCPCS J1568 vs. Other Drugs, Administered by Injection Codes
The HCPCS J1568 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 J1568 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 |
|---|---|---|
| 00069-6002-02-NDC | Moderate | OCTAGAM 10% (PF,LATEX-FREE) 100 MG/1 ML |
| 00069-6111-02-NDC | Moderate | OCTAGAM 10% (PF,LATEX-FREE) 100 MG/1 ML |
| 00069-6339-02-NDC | Moderate | OCTAGAM 10% (PF,LATEX-FREE) 100 MG/1 ML |
| J1568-HCPCS | Low | Injection, immune globulin, (Octagam), intravenous, non-lyophilized (e.g., liquid), 500 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J1568. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J1568 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like HCPCS J1568) and we'll show you how you compare in 15 minutes or less.