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See a sample rate comparisonHCPCS J8597 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.
Antiemetic drug, oral, not otherwise specified
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Chemotherapy Drugs, Oral and IV Administration |
| Common Place of Service | None 20 - Urgent Care Facility 11 - Office |
| Complexity Level | Low |
National average reimbursement for HCPCS J8597 by major payers:
$9.81
$1,000,000.00
$47.98
$286.88
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HCPCS J8597
5 of 6 sample ratesHigher to lower in this preview
Montefiore New Rochelle Hospital, Montefiore New Rochelle Professional Billing
Montefiore New Rochelle Hospital
$64.00Published rateSouth Nassau Communities Hospital
$64.00Published rateSouth Nassau Communities Hospital
$64.00Published rateMontefiore New Rochelle Hospital, Montefiore New Rochelle Professional Billing
Montefiore New Rochelle Hospital
$64.00Published rateMontefiore Mount Vernon Hospital, Montefiore Mount Vernon Professional Billing
Montefiore Mount Vernon Hospital
$64.00Published rate
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See a sample payer proposalHCPCS J8597 vs. Other Chemotherapy Drugs, Oral and IV Administration Codes
The HCPCS J8597 code is part of the Drugs Administered Other than Oral Method services used for Chemotherapy Drugs, Oral and IV Administration. 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 J8597 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 |
|---|---|---|
| J8565-HCPCS | Low | Gefitinib, oral, 250 mg |
| J8597-HCPCS | Low | Antiemetic drug, oral, not otherwise specified |
| J8600-HCPCS | Low | Melphalan; oral, 2 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J8597. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J8597 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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