HCPCS J9247 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 |
| Complexity Level | Moderate |
National average reimbursement for HCPCS J9247 by major payers:
$402.00
$524.28
$506.34
$516.95
| 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 J9247 | ||||||
United | J9247 | $489.25 | 1972954725 - RADIATION ONCOLOGY GROUP AT SBMC | 812497757 | NJ | Radiation Oncology Physician (2085R0001X) |
United | J9247 | $391.39 | 1689783961 - JASON LEVITZ | 222132567 | NJ | Hematology (Internal Medicine) Physician (207RH0000X) |
United | J9247 | $366.94 | 1689783961 - JASON LEVITZ | 222132567 | NJ | Hematology (Internal Medicine) Physician (207RH0000X) |
United | J9247 | $489.25 | 1851496152 - SSM HEALTH CARE ST. LOUIS, SSM HEALTH ST. CLARE HOSPITAL - FENTON | 431343281 - (MO) SSM HEALTH CARE ST LOUIS | MO | General Acute Care Hospital (282N00000X) |
United | J9247 | $489.25 | 1083710842 - WILLIAM KESSLER | 460961495 | NJ | Medical Oncology Physician (207RX0202X) |
United | J9247 | $518.60 | 1568454080 - NEIL MORGANSTEIN | 221919006 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9247 | $489.25 | 1023428273 - ADAM ZAYAC | 452548322 | NJ | Hematology (Internal Medicine) Physician (207RH0000X) |
United | J9247 | $489.25 | 1659516813 - JAMES ORSINI | 454832340 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9247 | $655.53 | 1861771784 - PANKHOORI SARAF | 223376459 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9247 | $538.17 | 1992951149 - JAMES MCCLOSKEY | 223141761 | NJ | Medical Oncology Physician (207RX0202X) |
United | J9247 | $547.96 | 1083940001 - CAMILA SAHEBI | 473868145 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9247 | $543.07 | 1710915269 - PRIYA GOR | 232865181 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9247 | $489.25 | 1174819577 - JOSEPH WEINER | 223371727 | NJ | Radiation Oncology Physician (2085R0001X) |
United | J9247 | $518.60 | 1477554418 - GLENDA SMITH | 205745047 | NJ | Radiation Oncology Physician (2085R0001X) |
United | J9247 | $489.25 | 1134428998 - KEVIN WOOD | 465285330 | 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 J9247 vs. Other Chemotherapy Drugs Codes
The HCPCS J9247 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 J9247 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 |
|---|---|---|
| J9246-HCPCS | Low | Injection, melphalan (evomela), 1 mg |
| J9247-HCPCS | Moderate | Injection, melphalan flufenamide, 1mg |
| J9250-HCPCS | Low | Methotrexate sodium, 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 J9247. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J9247 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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