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 | $31.00 | 1629070149 - SHORE MEMORIAL HOSPITAL | 210660835 - (NJ) SHORE MEMORIAL HOSPITAL | NJ | General Acute Care Hospital (282N00000X) |
United | J9070 | $21.29 | 1134221062 - MICHAEL MAROULES | 221487602 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9070 | $22.17 | 1740664515 - MIGUEL GONZALEZ VELEZ | 223141761 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9070 | $16.12 | 1407965775 - FAZAL BARI | 222132567 | NJ | Hematology (Internal Medicine) Physician (207RH0000X) |
United | J9070 | $16.12 | 1205947926 - TASNEEM RASHID | 223822818 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9070 | $22.43 | 1043482342 - ROBERT COLE | 223754338 | NJ | Radiation Oncology Physician (2085R0001X) |
United | J9070 | $36.66 | 1932208576 - UNIVERSITY OF NORTH CAROLINA HOSPITALS AT CHAPEL HILL, UNC HOSPITALS | 561118388 | NC | General Acute Care Hospital (282N00000X) |
United | J9070 | $20.14 | 1801800594 - PORTERCARE ADVENTIST HEALTH SYSTEM, ADVENTHEALTH PORTER | 841294507 | CO | General Acute Care Hospital (282N00000X) |
United | J9070 | $33.65 | 1497797088 - REX HOSPITAL INC., REX HOSPITAL | 561509260 - REX HOSPITAL INC | NC | General Acute Care Hospital (282N00000X) |
United | J9070 | $22.43 | 1255300141 - RICHARDS AFONJA | 421634032 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9070 | $21.37 | 1326041229 - ST MARYS HOSPITAL DECATUR OF THE HOSPITAL SISTERS OF THE THIRD ORDER, ST MARYS HOSPITAL | 370661244 - (IL) ST MARYS HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCIS | IL | General Acute Care Hospital (282N00000X) |
United | J9070 | $20.14 | 1265440903 - ADNAN DANISH | 300009812 | NJ | Radiation Oncology Physician (2085R0001X) |
United | J9070 | $21.36 | 1700880069 - JONATHAN BRIGGS | 823157047 | NJ | Radiation Oncology Physician (2085R0001X) |
United | J9070 | $33.50 | 1710491253 - NJMHMC, LLC, HUDSON REGIONAL HOSPITAL | 812857619 - (NJ) NJMHMC | NJ | General Acute Care Hospital (282N00000X) |
United | J9070 | $22.56 | 1083940001 - CAMILA SAHEBI | 473868145 | NJ | 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 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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