HCPCS J9059 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 | • Chemotherapy Drugs |
| Common Place of Service | • None • 11 - Office |
| Complexity Level | Low |
National average reimbursement for HCPCS J9059 by major payers:
$19.32
$16.80
$N/A
$17.72
| 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 J9059 | ||||||
United | J9059 | $16.94 | 1538547401 - CHARIS DURHAM | 742803009 - (TX) CANCER CLINIC | TX | Hematology & Oncology Physician (207RH0003X) |
United | J9059 | $20.86 | 1497778229 - PUNIT CHADHA | 752131429 - US ONCOLOGY CORPORATE, INC. | TX | Medical Oncology Physician (207RX0202X) |
United | J9059 | $96.12 | 1891871661 - TRI VU | 760386391 - KELSEY-SEYBOLD MEDICAL GROUP PLLC | TX | Hematology & Oncology Physician (207RH0003X) |
United | J9059 | $15.22 | 1083858443 - TIAN ZHANG | 756002868 | TX | Medical Oncology Physician (207RX0202X) |
United | J9059 | $20.86 | 1215197314 - JEFFREY YORIO | 752131429 - US ONCOLOGY CORPORATE, INC. | TX | Hematology & Oncology Physician (207RH0003X) |
United | J9059 | $20.86 | 1134161243 - ERIC NADLER | 752131429 - US ONCOLOGY CORPORATE, INC. | TX | Medical Oncology Physician (207RX0202X) |
United | J9059 | $20.86 | 1194011924 - ANANTH ARJUNAN | 752131429 - US ONCOLOGY CORPORATE, INC. | TX | Hematology & Oncology Physician (207RH0003X) |
United | J9059 | $20.86 | 1841637477 - BENJAMIN KITCHENS | 752131429 - US ONCOLOGY CORPORATE, INC. | TX | Hematology & Oncology Physician (207RH0003X) |
United | J9059 | $19.95 | 1285673012 - EDUARDO MIRANDA | 455552111 - (TX) ONCOLOGY HEMATOLOGY OF SOUTH TEXAS, PA | TX | Hematology & Oncology Physician (207RH0003X) |
United | J9059 | $15.22 | 1861495343 - JOHN SARANTOPOULOS | 742770530 - (TX) CANCER HEALTHCARE ASSOCIATES | TX | Medical Oncology Physician (207RX0202X) |
United | J9059 | $20.20 | 1285602565 - ALAIN MITA | 330676831 - HOAG CLINIC INC | TX | Medical Oncology Physician (207RX0202X) |
United | J9059 | $20.86 | 1497793509 - LALAN WILFONG | 752131429 - US ONCOLOGY CORPORATE, INC. | TX | Hematology & Oncology Physician (207RH0003X) |
United | J9059 | $15.22 | 1366828899 - PREETHI RAMACHANDRAN | 431080811 - (MO) EXCELSIOR SPRINGS CITY HOSPITAL | TX | Hematology & Oncology Physician (207RH0003X) |
United | J9059 | $15.82 | 1487864864 - REVA SCHNEIDER | 752536818 - HEALTHTEXAS PROVIDER NETWORK | TX | Medical Oncology Physician (207RX0202X) |
United | J9059 | $20.32 | 1962452474 - ROBYN YOUNG | 752512142 - (TX) ONCOLOGY-HEMATOLOGY CONSULTANTS, P.A. | TX | Hematology & Oncology Physician (207RH0003X) |
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 J9059 vs. Other Chemotherapy Drugs Codes
The HCPCS J9059 code is part of the Chemotherapy Drugs services . 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 J9059 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 |
|---|---|---|
| J9058-HCPCS | Low | Injection, bendamustine hydrochloride (apotex), 1 mg |
| J9059-HCPCS | Low | Injection, bendamustine hydrochloride (baxter), 1 mg |
| J9060-HCPCS | Low | Injection, cisplatin, powder or solution, 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 J9059. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J9059 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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