HCPCS J7342 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 • Miscellaneous Drugs |
| Common Place of Service | • None • 20 - Urgent Care Facility • 11 - Office |
| Complexity Level | Low |
National average reimbursement for HCPCS J7342 by major payers:

$31.53

$29.82

$30.56

$30.84
| 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 J7342 | ||||||
United | J7342 | $29.17 | 1073975942 - JENNIFER DROUET | 900603487 - (NY) PHYSICIAN AFFILIATE GROUP OF NEW YORK PC | NY | General Acute Care Hospital (282N00000X) |
United | J7342 | $29.17 | 1932112125 - CATHOLIC HEALTH INITIATIVES COLORADO, PENROSE HOSPITAL | 840405257 - CATHOLIC HEALTH INITIATIVES COLORADO | CO | General Acute Care Hospital (282N00000X) |
United | J7342 | $30.64 | 1538491949 - EISENHOWER MEDICAL CENTER, EISENHOWER | 956130458 - EISENHOWER MEDICAL CENTER | CA | General Acute Care Hospital (282N00000X) |
United | J7342 | $34.70 | 1629006457 - REGIONS HOSPITAL | 410797853 - GROUP HEALTH PLAN INC | MN | General Acute Care Hospital (282N00000X) |
United | J7342 | $34.34 | 1356391247 - ASPIRUS RHINELANDER & TOMAHAWK HOSPITALS & CLINICS, INC., ASPIRUS RHINELANDER & TOMAHAWK HOSPITALS & CLINICS, INC. | 390808443 - ASPIRUS STEVENS POINT HOSPITAL & CLINICS INC | WI | General Acute Care Hospital (282N00000X) |
United | J7342 | $27.79 | 1558364802 - MOBILE INFIRMARY ASSOCIATION, MOBILE INFIRMARY MEDICAL CENTER | 630288856 - (AL) MOBILE INFIRMARY ASSOCIATION | AL | General Acute Care Hospital (282N00000X) |
United | J7342 | $41.22 | 1841271459 - WEST VIRGINIA UNIVERSITY HOSPITALS, INC, WVU HOSPITALS, INC | 550643304 - WEST VIRGINIA UNIVERSITY HOSPITALS INC | WV | General Acute Care Hospital (282N00000X) |
United | J7342 | $85.34 | 1073708392 - MONTEFIORE MEDICAL CENTER | 131740114 - MONTEFIORE MEDICAL CENTER | NY | General Acute Care Hospital (282N00000X) |
United | J7342 | $40.84 | 1407803638 - ASCENSION NE WISCONSIN, INC, ASCENSION NE WISCONSIN-ST ELIZABETH CAMPUS | 390816818 - ASCENSION NE WISCONSIN INC | WI | General Acute Care Hospital (282N00000X) |
United | J7342 | $29.89 | 1487760906 - CAPE MEMORIAL HOSPITAL INC, CAPE CORAL HOSPITAL | 992646504 | FL | General Acute Care Hospital (282N00000X) |
United | J7342 | $29.17 | 1073933214 - SARAH O'NEIL | 463915494 - (NJ) ALLIED DIGESTIVE HEALTH, LLC | NJ | General Acute Care Hospital (282N00000X) |
United | J7342 | $29.17 | 1326097775 - WEST LOS ANGELES VAMC | 953626252 | CA | General Acute Care Hospital (282N00000X) |
United | J7342 | $29.17 | 1962451195 - BROOKDALE HOSPITAL MEDICAL CENTER, BROOKDALE EMERGENCY PHYSICIANS ASSOCIATES | 111631746 - BROOKDALE HOSPITAL MEDICAL CENTER | NY | General Acute Care Hospital (282N00000X) |
United | J7342 | $29.17 | 1194954289 - SOUTHERN MONTEREY COUNTY MEMORIAL HOSPITAL, GEORGE L. MEE MEMORIAL HOSPITAL | 941502014 - SOUTHERN MONTEREY COUNTY MEMORIAL HOSPITAL | CA | General Acute Care Hospital (282N00000X) |
United | J7342 | $34.41 | 1760584213 - REBECCA STONIS | 340714593 - CLEVELAND CLINIC HEALTH SYSTEM EAST REGION | OH | General Acute Care Hospital (282N00000X) |
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 |
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HCPCS J7342 vs. Other Miscellaneous Drugs Codes
The HCPCS J7342 code is part of the Drugs Administered Other than Oral Method services used for Miscellaneous Drugs. 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 J7342 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 |
|---|---|---|
| J7340-HCPCS | Moderate | Carbidopa 5 mg/levodopa 20 mg enteral suspension, 100 ml |
| J7342-HCPCS | Low | Instillation, ciprofloxacin otic suspension, 6 mg |
| J7345-HCPCS | Low | Aminolevulinic acid hcl for topical administration, 10% gel, 10 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J7342. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J7342 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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