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HCPCS J8610 (Methotrexate) 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.

Methotrexate; oral, 2.5 mg
Key FactDetail
Service Type

Drugs Administered Other than Oral Method

Chemotherapy Drugs, Oral and IV Administration

Common Place of Service

None

11 - Office

99 - Other POS

Complexity LevelLow
Medicaid Fee ScheduleView Medicaid rates for J8610
Medicare Payment Limit
$0.189BuyandBill.com
WAC Price
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Related NDC Codes

• 51927-1565-00 - METHOTREXATE (U.S.P.)


National average reimbursement for HCPCS J8610 by major payers:

bcbs

$0.26

uhc

$0.49

aetna

$0.32

cigna

$0.27

Compare published rates across providers.

Choose a payer to see a sample of rates for HCPCS J8610.

HCPCS J8610
5 of 25 sample ratesHigher to lower in this preview
  1. South Nassau Communities Hospital

    NYGeneral Acute Care HospitalNPI 1922079094Tax ID 11-1352310

    $64.00Published rate
  2. Brigham & Women'S Hospital

    Mass General Brigham Incorporated

    MAGeneral Acute Care HospitalNPI 1871704833Tax ID 42-312909

    $0.30Published rate
  3. Jefferson Hospital Association Inc, Jefferson Regional Medical Center

    Jefferson Hospital Assn Inc

    ARGeneral Acute Care HospitalNPI 1710931985Tax ID 71-0329353

    $0.21Published rate
  4. Banner Baywood Medical Center

    AZGeneral Acute Care HospitalNPI 1194758284Tax ID 36-3386394

    $0.18Published rate
  5. Mercy Medical Center

    NYGeneral Acute Care HospitalNPI 1659330173Tax ID 11-1635088

    $0.10Published rate

National sample. Rates vary by location, specialty, and contract.

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HCPCS J8610 vs. Other Chemotherapy Drugs, Oral and IV Administration Codes

The HCPCS J8610 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 J8610 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
51927-1565-00-NDCModerateMETHOTREXATE (U.S.P.)
J8600-HCPCSLowMelphalan; oral, 2 mg
J8610-HCPCSLowMethotrexate; oral, 2.5 mg

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J8610. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the J8610 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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