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See a sample rate comparisonHCPCS J8611 (Jylamvo) 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 (jylamvo), oral, 2.5 mg
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Chemotherapy Drugs, Oral and IV Administration |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | View Medicaid rates for J8611 |
| Medicare Payment Limit | $18.466  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS J8611 by major payers:
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HCPCS J8611
5 of 25 sample ratesHigher to lower in this preview
Chattanooga Hamilton County Hospital Authority, Erlanger Medical Center
Erlanger Medical Center
$25.57Published rateCatholic Health Initiatives Colorado, Penrose Hospital
Catholic Health Initiatives Colorado
$20.94Published rateKennedy University Hospital Inc.
Kennedy University Hospital Inc
$19.36Published rateMonument Health Rapid City Hospital, Inc., Monument Health Neurology And Rehabilitation
Monument Health Rapid City Hospital Inc
$18.80Published rateRabi Upadhyay
New York City Health And Hospitals Corporation
$12.43Published rate
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See a sample payer proposalHCPCS J8611 vs. Other Chemotherapy Drugs, Oral and IV Administration Codes
The HCPCS J8611 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 J8611 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 |
|---|---|---|
| J8611-HCPCS | Moderate | Methotrexate (jylamvo), 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 J8611. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J8611 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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