HCPCS J9070 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 • 22 - On Campus Outpatient Hospital |
| Complexity Level | Low |
National average reimbursement for HCPCS J9070 by major payers:
$39.21
$33.36
$N/A
$23.79
| 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 J9070 | ||||||
United | J9070 | $21.36 | 1407805971 - SOUTHWEST MISSISSIPPI REGIONAL MEDICAL CENTER | 640468873 | MS | General Acute Care Hospital (282N00000X) |
United | J9070 | $54.47 | 1356828172 - HMH HOSPITALS CORPORATION, RARITAN BAY MEDICAL CENTER-OLD BRIDGE | 221487576 - HACKENSACK MERIDIAN HEALTH INC | NJ | General Acute Care Hospital (282N00000X) |
United | J9070 | $20.14 | 1548295306 - SETH COHEN | 222362154 | NJ | Medical Oncology Physician (207RX0202X) |
United | J9070 | $15.10 | 1285743542 - NAVEED JAN | 222132567 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9070 | $21.36 | 1700880069 - JONATHAN BRIGGS | 823157047 | NJ | Radiation Oncology Physician (2085R0001X) |
United | J9070 | $20.14 | 1215960232 - LOUISE LIGRESTI | 454832340 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9070 | $20.14 | 1104870450 - GOPAL DESAI | 222405291 | NJ | Radiation Oncology Physician (2085R0001X) |
United | J9070 | $17.13 | 1629069638 - ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL AT HAMILTON | 210634572 - (NJ) RWJ BARNABAS HEALTH INC | NJ | General Acute Care Hospital (282N00000X) |
United | J9070 | $20.14 | 1598761355 - UPPER CHESAPEAKE MEDICAL CENTER, INC., UNIVERSITY OF MARYLAND UPPER CHESAPEAKE MEDICAL CENTER | 521253920 - (MD) UPPER CHESAPEAKE MEDICAL CENTER INC | MD | General Acute Care Hospital (282N00000X) |
United | J9070 | $20.14 | 1154824936 - XIAOYI CHEN | 223371727 | NJ | Hematology (Internal Medicine) Physician (207RH0000X) |
United | J9070 | $22.43 | 1508805839 - HAI SUN PARK | 831286496 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9070 | $23.02 | 1992142046 - WILLIAM RAFELSON | 202088165 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9070 | $22.43 | 1790768125 - MICHAEL MARCHESE | 262245205 | NJ | Radiation Oncology Physician (2085R0001X) |
United | J9070 | $20.14 | 1316320237 - ASHWIN CHANDAR | 461420853 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9070 | $16.12 | 1407965775 - FAZAL BARI | 222132567 | NJ | Hematology (Internal Medicine) Physician (207RH0000X) |
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 J9070 vs. Other Chemotherapy Drugs Codes
The HCPCS J9070 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 J9070 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 |
|---|---|---|
| J9065-HCPCS | Low | Injection, cladribine, per 1 mg |
| J9070-HCPCS | Low | Cyclophosphamide, 100 mg |
| J9071-HCPCS | Low | Injection, cyclophosphamide, (auromedics), 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 J9070. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J9070 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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