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See a sample rate comparisonHCPCS J8612 (Xatmep) 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 (xatmep), oral, 2.5 mg
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Chemotherapy Drugs, Oral and IV Administration |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J8612 |
| Medicare Payment Limit | $22.68  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS J8612 by major payers:
$22.50
$21.11
$42.80
$25.87
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HCPCS J8612
5 of 25 sample ratesHigher to lower in this preview
University Of California San Francisco Medical Center, Ucsf Medical Center
$42.81Published rateBaptist Health Care, Inc., Gulf Breeze Hospital
Baptist Health Care Inc
$24.71Published rateSpartanburg Medical Center, Spartanburg Medical Center Professional Services
$20.47Published rateBanner Thunderbird Medical Center
$19.69Published rateSt Francis Hospital, St Frances Pathology
St Francis Hospital
$19.38Published rate
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See a sample payer proposalHCPCS J8612 vs. Other Chemotherapy Drugs, Oral and IV Administration Codes
The HCPCS J8612 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 J8612 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 |
|---|---|---|
| J8612-HCPCS | Low | Methotrexate (xatmep), 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 J8612. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J8612 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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