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    HCPCS Details

    HCPC J9250
    Short Description Methotrexate sodium inj
    Long Description Methotrexate sodium, 5 mg
    Pricing indicator 51
    Coverage code D
    ASC payment group code
    BETOS2 code O1D
    Action code N
    Type of service 1
    Effective date 1997-01-01
    Date Added 1994-01-01

    HCPCS/NDC Cross-Walk

    NDC HCPC Description Drug Name Labeler Name HCPCS Dosage PKG Size PKG QTY Bill Units Bill Units PKG
    00143951910 J9250 Methotrexate sodium inj Methotrexate Sodium HIKMA PHARMACEUTICALS USA INC. 5 MG 2 10 10 100
    00143983001 J9250 Methotrexate sodium inj Methotrexate Sodium HIKMA PHARMACEUTICALS USA INC. 5 MG 1 1 200 200
    00703367101 J9250 Methotrexate sodium inj Methotrexate Sodium SICOR PHARMACEUTICALS, INC. 5 MG 2 1 10 10
    00703367501 J9250 Methotrexate sodium inj Methotrexate Sodium SICOR PHARMACEUTICALS, INC. 5 MG 10 1 50 50
    00703367801 J9250 Methotrexate sodium inj Methotrexate Sodium SICOR PHARMACEUTICALS, INC. 5 MG 40 1 200 200
    00703367881 J9250 Methotrexate sodium inj Methotrexate Sodium SICOR PHARMACEUTICALS, INC. 5 MG 40 1 200 200
    16729027703 J9250 Methotrexate sodium inj Methotrexate Sodium ACCORD HEALTHCARE INC. 5 MG 10 1 50 50
    16729027730 J9250 Methotrexate sodium inj Methotrexate Sodium ACCORD HEALTHCARE INC. 5 MG 2 1 10 10
    16729027735 J9250 Methotrexate sodium inj Methotrexate Sodium ACCORD HEALTHCARE INC. 5 MG 40 1 200 200
    61703012440 J9250 Methotrexate sodium inj METHOTREXATE HOSPIRA, INC. 5 MG 40 1 200 200
    61703035010 J9250 Methotrexate sodium inj Methotrexate Sodium PFIZER INC. 5 MG 2 5 10 50
    61703035038 J9250 Methotrexate sodium inj METHOTREXATE PFIZER INC. 5 MG 2 5 10 50
    61703040825 J9250 Methotrexate sodium inj Methotrexate Sodium PFIZER INC. 5 MG 40 1 200 200
    61703040841 J9250 Methotrexate sodium inj Methotrexate Sodium PFIZER INC. 5 MG 40 1 200 200
    63323012250 J9250 Methotrexate sodium inj Methotrexate PoWder 1Gm In 50Ml Sd Vial (P.F.) FRESENIUS KABI 5 MG 1 1 200 200
    63323012310 J9250 Methotrexate sodium inj Methotrexate Sodium FRESENIUS KABI 5 MG 10 1 50 50
    The ASP crosswalks are maintained by the Division of Data Analysis and Market Based Pricing to support ASP-based Medicare Part B payments only. The crosswalks are intended to help the public (including entities that submit manufacturer ASP data and providers who bill for drugs) understand which drug products (identified by NDCs) are assigned to which HCPCS billing codes. The crosswalks are not intended to be a comprehensive list of all drugs/NDCs available in the United States. The NDC to HCPCS Crosswalk also includes information on the NDC package size and the number of billable units (as defined by the HCPCS code descriptor). Comments on the file may be sent to [email protected].

    HCPCS Billing Calculator

    Dosage given to patient (per dose)
    HCPCS Dosage 5 MG
    HCPCS/CPT Billing Units 0.2
    Total doses ordered
    Billing Units 0.2