HCPCS J9262 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 J9262 by major payers:
$4.17
$4.85
$4.66
$4.11
| 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 J9262 | ||||||
United | J9262 | $4.09 | 1891717708 - STEPHEN ABO | 454832340 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9262 | $5.07 | 1780150342 - NEW JERSEY CANCER AND INTEGRATED MEDICINE CENTER, LLC | 831286496 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9262 | $3.97 | 1104870450 - GOPAL DESAI | 810889110 | NJ | Radiation Oncology Physician (2085R0001X) |
United | J9262 | $4.55 | 1215960232 - LOUISE LIGRESTI | 223403774 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9262 | $4.82 | 1548715998 - JOSEPH HO | 222306123 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9262 | $4.55 | 1023428273 - ADAM ZAYAC | 452548322 | NJ | Hematology (Internal Medicine) Physician (207RH0000X) |
United | J9262 | $5.01 | 1144518457 - KIMBERLY SALWITZ | 223141761 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9262 | $3.65 | 1407862519 - NILOO PRASAD | 223439054 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9262 | $4.09 | 1285734301 - MAYA SHAH | 223680355 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9262 | $5.07 | 1891717708 - STEPHEN ABO | 464581706 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9262 | $4.55 | 1588820708 - SEEMA VARMA | 223316007 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9262 | $4.69 | 1295170058 - DAVID GUTTMANN | 320577172 | NJ | Radiation Oncology Physician (2085R0001X) |
United | J9262 | $6.11 | 1619039260 - JENIA JENAB-WOLCOTT | 150532221 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9262 | $5.01 | 1578596508 - ROBERT TASSAN | 223141761 | NJ | Hematology (Internal Medicine) Physician (207RH0000X) |
United | J9262 | $4.09 | 1588820708 - SEEMA VARMA | 223316007 | 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 J9262 vs. Other Chemotherapy Drugs Codes
The HCPCS J9262 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 J9262 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 |
|---|---|---|
| J9261-HCPCS | Low | Injection, nelarabine, 50 mg |
| J9262-HCPCS | Low | Injection, omacetaxine mepesuccinate, 0.01 mg |
| J9263-HCPCS | Low | Injection, oxaliplatin, 0.5 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J9262. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J9262 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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