J9250 is terminated (historical record)
Descriptors and administrative fields exactly as published in the CMS HCPCS quarterly file.
Billing context: J-codes
Units are reported in multiples of the dosage in the code descriptor.
One HCPCS billing unit of J9250
5 MG
No published MUE for J9250. CMS keeps some MUE values confidential, so this does not mean there is no daily unit limit.
Medicare Part B drug payment limits per billing unit, by quarter, from the CMS payment limit (ASP) files.
Most recent Medicare Part B payment limit · Q1 2024
$0.307per 5 MG
Effective Jan 1, 2024 – Mar 31, 2024 · ASP methodology (per CMS file) · based on Q3 2023 ASP data · coinsurance 20.000%
Not in the latest payment limit file (Q4 2026). Shown for history only.
| Quarter | Effective | Payment limit | Per (billing unit) | Coinsurance | Change | CMS notes |
|---|---|---|---|---|---|---|
| Q1 2024 | Jan 1, 2024 – Mar 31, 2024 | $0.307 | 5 MG | 20% | +31.8% | — |
| Q4 2023 | Oct 1, 2023 – Dec 31, 2023 | $0.233 | 5 MG | 20% | −15.0% | — |
| Q3 2023 |
Medicare hospital outpatient (OPPS)
No authoritative public data was located for this field.
Washington Apple Health · professional claims
Not on HCA's professional administered drug fee schedule.
AAC = actual acquisition cost, based on NDC or invoice; BR = by report; NC = not covered; DC = not covered, see a different code; DP = covered under another program (see comments); PA = prior authorization; EPA = expedited prior authorization (see the billing guide); CPA = contractor prior authorization (Qualis). For professional claims; hospital-administered drugs are paid under HCA's outpatient (OPPS/EAPG) rules.
Packages CMS assigns to this code in its NDC–HCPCS crosswalks, with billable units per package. Only official crosswalk rows are shown.
No CMS NDC–HCPCS crosswalk rows were located. CMS notes its crosswalks are not a comprehensive list of all NDCs.
| NDC (11-digit) | CMS drug name · labeler | Pkg size × qty | Units / item | Units / NDC | Crosswalk | Quarters | FDA listing |
|---|---|---|---|---|---|---|---|
| 16729-0277-03 | Methotrexate SodiumACCORD HEALTHCARE INC. | 10 × 1 | 50 | 50 | ASP | Q1 2021 – Q1 2024Not in Q4 2026 file | ListedMethotrexate |
| 16729-0277-30 | Methotrexate SodiumACCORD HEALTHCARE INC. | 2 × 1 | 10 | 10 | ASP | Q1 2021 – Q1 2024Not in Q4 2026 file | ListedMethotrexate |
| 16729-0277-35 | Methotrexate SodiumACCORD HEALTHCARE INC. | 40 × 1 | 200 | 200 | ASP | Q1 2021 – Q1 2024Not in Q4 2026 file | ListedMethotrexate |
| 63323-0122-50 | Methotrexate PoWder 1Gm In 50Ml Sd Vial (P.F.)FRESENIUS KABI | 1 × 1 | 200 | 200 | ASP | Q1 2021 – Q1 2024Not in Q4 2026 file | ListedMethotrexate |
| 63323-0123-10 | Methotrexate SodiumFRESENIUS KABI | 10 × 1 | 50 | 50 | ASP | Q1 2021 – Q1 2024Not in Q4 2026 file | ListedMethotrexate |
| 00143-9519-10 | Methotrexate SodiumHIKMA PHARMACEUTICALS USA INC. | 2 × 10 | 10 | 100 | ASP | Q1 2021 – Q1 2024Not in Q4 2026 file | ListedMethotrexate |
| 00143-9830-01 | Methotrexate SodiumHIKMA PHARMACEUTICALS USA INC. | 1 × 1 | 200 | 200 | ASP | Q1 2021 – Q1 2024Not in Q4 2026 file | ListedMethotrexate |
| 61703-0124-40 | METHOTREXATEHOSPIRA, INC. | 40 × 1 | 200 | 200 | ASP | Q3 2023 – Q1 2024Not in Q4 2026 file | ListedMethotrexate |
| 67457-0466-10 | Methotrexate SodiumMYLAN INSTITUTIONAL LLC | 10 × 1 | 50 | 50 | ASP | Q1 2021 – Q4 2023Not in Q4 2026 file | Excluded listingMethotrexate |
| 67457-0480-40 | Methotrexate SodiumMYLAN INSTITUTIONAL LLC | 40 × 1 | 200 | 200 | ASP | Q1 2021 – Q4 2023Not in Q4 2026 file | Excluded listingMethotrexate |
| 61703-0350-10 | Methotrexate SodiumPFIZER INC. | 2 × 5 | 10 | 50 | ASP | Q1 2021 – Q1 2024Not in Q4 2026 file | ListedMethotrexate |
| 61703-0350-38 | METHOTREXATEPFIZER INC. | 2 × 5 | 10 | 50 | ASP | Q1 2021 – Q1 2024Not in Q4 2026 file | ListedMethotrexate |
| 61703-0408-25 | Methotrexate SodiumPFIZER INC. | 40 × 1 | 200 | 200 | ASP | Q2 2022 – Q1 2024Not in Q4 2026 file | ListedMethotrexate |
| 61703-0408-41 | Methotrexate SodiumPFIZER INC. | 40 × 1 | 200 | 200 | ASP | Q1 2021 – Q1 2024Not in Q4 2026 file | ListedMethotrexate |
| 00703-3671-01 | Methotrexate SodiumSICOR PHARMACEUTICALS, INC. | 2 × 1 | 10 | 10 | ASP | Q1 2021 – Q1 2024Not in Q4 2026 file | ListedMethotrexate |
| 00703-3671-03 | Methotrexate SodiumSICOR PHARMACEUTICALS, INC. | 2 × 10 | 10 | 100 | ASP | Q1 2021 – Q3 2022Not in Q4 2026 file | Excluded listingMethotrexate |
| 00703-3675-01 | Methotrexate SodiumSICOR PHARMACEUTICALS, INC. | 10 × 1 | 50 | 50 | ASP | Q1 2021 – Q1 2024Not in Q4 2026 file | ListedMethotrexate |
| 00703-3678-01 | Methotrexate SodiumSICOR PHARMACEUTICALS, INC. | 40 × 1 | 200 | 200 | ASP | Q1 2021 – Q1 2024Not in Q4 2026 file | ListedMethotrexate |
| 00703-3678-81 | Methotrexate SodiumSICOR PHARMACEUTICALS, INC. | 40 × 1 | 200 | 200 | ASP | Q1 2021 – Q1 2024Not in Q4 2026 file | Excluded listingMethotrexate |
Medicare coverage is set nationally (NCDs) and by each Medicare Administrative Contractor (LCDs and Billing & Coding articles). These links open the official documents.
Verification neededCodeRx links to coverage documents instead of copying them: CMS distributes their code lists under AMA, ADA, and AHA license terms that limit reuse. Medicare Advantage, Medicaid, and commercial plans set their own coverage and prior-authorization rules.
Changes detected between the CMS quarterly HCPCS files CodeRx has imported.
| Quarterly file | Change | CMS action code | Details |
|---|---|---|---|
| Q2 2024 | Termination date set | D — Discontinued | Termination date Mar 31, 2024 |
| Q1 2023 | In earliest ingested file | N — No maintenance | Added date Jan 1, 1994 |
All imported releases, checksums, and import reports are listed on the data sources page.
Disclaimer. This application provides informational coding and reimbursement reference data. It does not constitute legal, clinical, coding, or billing advice. Codes, payment amounts, payer rules, and coverage policies can change. Verify all information with current CMS publications, the applicable payer, and your organization’s compliance policies before submitting a claim. CodeRx is not affiliated with or endorsed by CMS, FDA, Medicare, or any payer.
| Jul 1, 2023 – Sep 30, 2023 |
| $0.274 |
| 5 MG |
| 20% |
| +11.8% |
| — |
| Q2 2023 | Apr 1, 2023 – Jun 30, 2023 | $0.245 | 5 MG | 20% | +11.9% | — |
|---|
| Q1 2023 | Jan 1, 2023 – Mar 31, 2023 | $0.219 | 5 MG | — | −16.4% | — |
|---|
| Q4 2022 | Oct 1, 2022 – Dec 31, 2022 | $0.262 | 5 MG | — | +33.0% | — |
|---|
| Q3 2022 | Jul 1, 2022 – Sep 30, 2022 | $0.197 | 5 MG | — | −16.5% | — |
|---|
| Q2 2022 | Apr 1, 2022 – Jun 30, 2022 | $0.236 | 5 MG | — | +14.0% | — |
|---|
| Q1 2022 | Jan 1, 2022 – Mar 31, 2022 | $0.207 | 5 MG | — | −4.2% | — |
|---|
| Q4 2021 | Oct 1, 2021 – Dec 31, 2021 | $0.216 | 5 MG | — | −3.1% | — |
|---|
| Q3 2021 | Jul 1, 2021 – Sep 30, 2021 | $0.223 | 5 MG | — | +5.7% | — |
|---|
| Q2 2021 | Apr 1, 2021 – Jun 30, 2021 | $0.211 | 5 MG | — | +0.5% | — |
|---|
| Q1 2021 | Jan 1, 2021 – Mar 31, 2021 | $0.210 | 5 MG | — | — | — |
|---|