J8610
J8610 – Methotrexate; oral, 2.5 mg · NDC Crosswalk & Billing Units
HCPCS Level II J-code · Medicare Part B drug billing
J-code
● 20 NDCs crosswalked per 2.5 MG $0.154/unit ASP+6%
📋 J8610 summary
J8610 is a HCPCS Level II J-code used to bill Methotrexate; oral, 2.5 mg, billed per 2.5 MG. The number of billing units to report depends on the dose administered and the NDC/package billed — use the calculator below.
Brand names associated with J8610: Methotrexate*, Methotrexate Sodium, Methotrexate
Code J8610
Billing unit 2.5 MG Payment limit $0.154/unit NDC-Crosswalk 20
Quarter Q3 2026
RxCUI Atlas Trace the drug concept →
⚠ An NDC↔HCPCS crosswalk and a published payment limit do not guarantee payer coverage or payment. Always verify the current payer policy and claim format before billing.
🗂️ Key billing facts
HCPCS codeJ8610
DescriptorMethotrexate; oral, 2.5 mg
Billing unit2.5 MG
Payment limit / unit$0.154
Est. ASP / unit$0.145 est.
Mapped NDCs20
Data periodQ3 2026
Last updated2026-08-20
💊 About Methotrexate DRUG GUIDE
Methotrexate treats a wide range of serious conditions.
In cancer care, it is used for acute lymphoblastic leukemia, non-Hodgkin lymphoma, osteosarcoma, breast cancer, head and neck cancer, and gestational trophoblastic neoplasia (a rare tumor related to pregnancy).
It is also used to prevent and treat meningeal leukemia (cancer affecting the lining of the brain and spinal cord).Outside of cancer, methotrexate is prescribed for adults with rheumatoid arthritis (RA), children with polyarticular juvenile idiopathic arthritis (a form of childhood arthritis), and adults with severe psoriasis that hasn't responded well to other treatments.
Clinical overview from our editorial drug guide for Methotrexate. For billing reference, see the sections above.
🧾 Billing & reimbursement HCPCS · CMS · EFF. Q3 2026
📅 Payment limits effective Q3 2026 — from the CMS Medicare Part B Payment Limit File (revised quarterly).
Medicare payment limit / unit
$0.154
Est. ASP / unit
$0.145 est.
Est. after 2% sequester
$0.151
HCPCS dosage
2.5 MG
The CMS payment limit is the Medicare Part B drug allowance (ASP + 6%, statutory). After the 2% federal sequester the effective payment is ≈ ASP + 4.3%; estimated ASP = payment limit ÷ 1.06. Source: CMS Medicare Part B Payment Limit File (quarterly), Q3 2026.
Full HCPCS code details (official CMS record)
Long descriptionMethotrexate; oral, 2.5 mg
CoverageD — Special coverage instructions apply
Pricing indicator51 — Drug — priced under the ASP methodology
Type of service1 — Medical care
BETOS-2O1D
ASC payment group—
Action codeN — No maintenance this year
Effective date1997-08-31
Date added1995-01-01
Source: CMS HCPCS Level II code file (imported via admin).
🧮 Dosing & billing-units calculator HCPCS UNITS
One billing unit of J8610 = 2.5 mg. Enter a regimen to convert dose → billing units and project a full course.
Billing units = dose ÷ HCPCS unit size. Most payers require whole units — round per the payer's policy. “Est. Medicare pay” uses the current payment limit. For single-dose vials, drug discarded after administration may be separately billable with modifier JW (JZ when none is discarded) where allowed. Always verify payer-specific rounding before billing.
🔁 NDCs that bill under J8610 LEAST EXPENSIVE FIRST
20 NDCs map to J8610. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($0.154/unit) × that package's bill units.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | Est. pay / pkg | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|---|
| 00054-4550-25 | Methotrexate Sodium 2.5 mg/1 TABLET | Hikma | 100 TABLET in 1 BOTTLE, PLASTIC (0054-4550... | 2.5 mg/1 | 100 | $15.40 | $0.157 | ● Active | CMS ASP |
| 00378-0014-01 | Methotrexate 2.5 mg/1 TABLET | Mylan | 100 TABLET in 1 BOTTLE, PLASTIC (0378-0014... | 2.5 mg/1 | 100 | $15.40 | $0.157 | ● Active | CMS ASP |
| 00555-0572-02 | Methotrexate 2.5 mg/1 TABLET | Teva | 100 TABLET in 1 BOTTLE (0555-0572-02) | 2.5 mg/1 | 100 | $15.40 | $0.157 | ● Active | CMS ASP |
| 00555-0572-35 | Methotrexate 2.5 mg/1 TABLET | Teva | 36 TABLET in 1 BOTTLE (0555-0572-35) | 2.5 mg/1 | 36 | $5.54 | $0.157 | ● Active | CMS ASP |
| 00904-7141-10 | Methotrexate 2.5 mg/1 TABLET | Major | 20 BLISTER PACK in 1 CARTON (0904-7141-10)... | 2.5 mg/1 | 20 | $3.08 | $0.157 | ● Active | CMS ASP |
| 16729-0486-01 | Methotrexate 2.5 mg/1 TABLET | Accord | 100 TABLET in 1 BOTTLE (16729-486-01) | 2.5 mg/1 | 100 | $15.40 | $0.157 | ● Active | CMS ASP |
| 47335-0235-83 | Methotrexate 2.5 mg/1 TABLET | Sun | 100 TABLET in 1 BOTTLE (47335-235-83) | 2.5 mg/1 | 100 | $15.40 | $0.157 | ● Active | CMS ASP |
| 47335-0235-96 | Methotrexate 2.5 mg/1 TABLET | Sun | 36 TABLET in 1 BOTTLE (47335-235-96) | 2.5 mg/1 | 36 | $5.54 | $0.157 | ● Active | CMS ASP |
| 51079-0670-05 | Methotrexate 2.5 mg/1 TABLET | Mylan | 20 BLISTER PACK in 1 CARTON (51079-670-05)... | 2.5 mg/1 | 20 | $3.08 | $0.157 | ● Active | CMS ASP |
| 59651-0182-01 | Methotrexate 2.5 mg/1 TABLET | Aurobindo | 100 TABLET in 1 BOTTLE (59651-182-01) | 2.5 mg/1 | 100 | $15.40 | $0.157 | ● Active | CMS ASP |
| 51285-0366-01 | Trexall Methotrexate 5 mg/1 TABLET, FILM COATED | Teva | 30 TABLET, FILM COATED in 1 BOTTLE (51285-... | 5 mg/1 | 60 | $9.24 | $24.088 | ● Active | CMS ASP |
| 51285-0367-01 | Trexall Methotrexate 7.5 mg/1 TABLET, FILM COATED | Teva | 30 TABLET, FILM COATED in 1 BOTTLE (51285-... | 7.5 mg/1 | 90 | $13.86 | $36.209 | ● Active | CMS ASP |
| 51285-0368-01 | Trexall Methotrexate 10 mg/1 TABLET, FILM COATED | Teva | 30 TABLET, FILM COATED in 1 BOTTLE (51285-... | 10 mg/1 | 120 | $18.48 | $48.135 | ● Active | CMS ASP |
| 00054-8550-25 | Methotrexate | Hikma | — | — | 100 | $15.40 | — | — | CMS ASP |
| 50090-3418-09 | Methotrexate | A-S | — | — | 36 | $5.54 | — | — | CMS ASP |
| 50090-5457-02 | Methotrexate | A-S | — | — | 100 | $15.40 | — | — | CMS ASP |
| 50090-5457-09 | Methotrexate 2.5 mg/1 TABLET | A-S | 36 TABLET in 1 BOTTLE (50090-5457-9) | 2.5 mg/1 | 36 | $5.54 | — | ● Active | CMS ASP |
| 50268-0527-15 | Methotrexate | AvPAK | — | — | 50 | $7.70 | — | — | CMS ASP |
| 51285-0369-01 | Trexall Methotrexate 15 mg/1 TABLET, FILM COATED | Teva | 30 TABLET, FILM COATED in 1 BOTTLE (51285-... | 15 mg/1 | 180 | $27.72 | — | ● Active | CMS ASP |
| 51927-1565-00 | METHOTREXATE 1 kg/kg POWDER | Professional | 1 kg in 1 CONTAINER (51927-1565-0) | 1 kg/kg | 400 | $61.60 | — | ● Active | PDAC |
NDC→HCPCS mappings come from the CMS ASP NDC-HCPCS crosswalk; additional DME MAC / DMEPOS mappings come from PDAC and are labeled separately. NADAC from CMS (weekly). “Status” reflects the product's marketing / obsolete flag in the NDC directory. Presence or absence here does not determine Medicare coverage. Linked NDCs open the full product page.
📊 Medicare utilization & spend CMS · PART B · 2026 (Q1)
Period
Total Part B spend
$338.59
Claims
81
Beneficiaries
45
Spend / beneficiary
$7.52
Spend / claim
$4.18
Trend by period
Where J8610 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #793 of 824
#788
AFLURIA (90657)* 90657
$440.18
#789
AZITHROMYCIN* J0456
$419.17
#790
VALPROATE SODIUM J3379
$414.28
#791
HYDROXYZINE HCL J3410
$391.37
#792
FOLIC ACID J1808
$341.31
#793
METHOTREXATE* J8610
$338.59
#794
PHENYLEPHRINE HCL-0.... J2371
$334.54
#795
CALCIUM GLUCONATE-NA... J0613
$319.51
#796
FLUCONAZOLE-NACL J1450
$308.26
#797
METHADONE HCL J1230
$278.72
#798
LABETALOL HCL J1920
$273.36
Total claims — #647 of 824
#642
BUTORPHANOL TARTRATE J0595
88
#643
CYTOGAM J0850
88
#644
SEVENFACT J7212
87
#645
GEMCITABINE HCL(J919... J9196
86
#646
BKEMV Q5152
84
#647
METHOTREXATE* J8610
81
#648
PURAPLY 1 SQ CM** Q4195
80
#649
XWRAP 1 SQ CM** Q4204
80
#650
PROCAINAMIDE HCL J2690
79
#651
VALPROATE SODIUM J3379
79
#652
KEPPRA* J1953
75
Top Medicare Part B drugs by the selected metric. Click any drug to open its J-code page. Source: CMS Medicare Quarterly Part B Spending by Drug.
Full breakdown by period (2)
| Period | Total spend | Beneficiaries | Claims | $/beneficiary | $/claim |
|---|---|---|---|---|---|
| 2026 (Q1) | $338.59 | 45 | 81 | $7.52 | $4.18 |
| 2025 (Q1-Q4) | $2.2K | 96 | 433 | $22.98 | $5.09 |
Provider-administered (Part B) spend, calculated for the whole HCPCS code (CMS does not publish Medicare spend per individual NDC). Self-administered use is covered under Part D instead. A blank patient count means fewer than 11 people — CMS hides counts that small to protect privacy. Source: CMS Medicare Quarterly Part B Spending by Drug (data.cms.gov), updated quarterly.
📈 Medicare Part B claims detail CMS PSPS · 2024
Calendar-year 2024 Medicare Part B fee-for-service activity for this HCPCS code, summed across all carriers, localities and specialties (CMS Physician/Supplier Procedure Summary). A “service” is one billed line/unit — not one claim — so counts run higher than claim counts.
Allowed charges
$30.48
Medicare paid
$23.90
Submitted services
885
Denial rate
81.9%
Allowed / service
$0.19
Submitted charges
$948.33
Source: CMS Physician/Supplier Procedure Summary (PSPS), CY2024 — Medicare Part B carrier + DME fee-for-service claims (excludes Medicare Advantage). Figures are for the whole HCPCS code, which may cover uses beyond this drug. ⚠ CMS hides any figure covering fewer than 11 patients (a privacy rule), so totals — especially denials and low-volume codes — run a little low.
📊 What bills under J8610
J-codes are billing codes often used for drugs billed under the medical benefit. This connects the billing code to the NDC package records it covers, by ingredient and labeler.
NDC products by ingredient
NDC products by labeler
🗃️ Data sources & freshness
Every figure on this page is computed from public datasets. Here's what each section draws on and how current it is.
HCPCS code & descriptor
CMS HCPCS Level II code file
Loaded
Payment limit & billing unit
CMS Medicare Part B ASP Pricing File (quarterly)
Q3 2026 · as of 2026-08-20
NDC ↔ HCPCS crosswalk
CMS ASP NDC-HCPCS crosswalk + DMEPDAC (PDAC)
20 NDCs mapped
NADAC acquisition cost
CMS National Average Drug Acquisition Cost (weekly)
Available for mapped NDCs
Utilization & spend
CMS Part B Spending by Drug · PSPS · Physician & Other Practitioners
Latest data year 2026
Figures are estimates for reference and may lag the source files. Always verify against the current CMS files and your payer's policy before submitting claims.
⚠️ Practical billing caveats
- A crosswalk is not coverage. An NDC mapping or a published payment limit does not guarantee a payer will cover or pay this code. Check the specific plan's policy.
- Units ≠ milligrams. Bill the number of HCPCS units (dose ÷ the code's unit size), not the milligram dose. Use the calculator above.
- Discarded drug. For single-dose vials, drug discarded after administration may be separately billable with modifier JW (and JZ when nothing is discarded) where the payer allows.
- Rounding & partial units. Many payers require whole units; round per the payer's policy, not automatically up.
- The code can cover more than this drug. Some HCPCS codes span multiple products or strengths — confirm the exact code for the product administered.
- Figures lag. ASP limits change quarterly and utilization data are released with a delay. Verify against the current CMS files before billing.
❓ J8610 billing FAQ
What is HCPCS code J8610?
J8610 is a HCPCS Level II J-code used to bill Methotrexate; oral, 2.5 mg under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J8610?
One unit of J8610 represents 2.5 MG. Report the number of units equal to the dose administered divided by 2.5 MG.
How many units of J8610 should I bill?
Divide the dose administered by the code's unit size (2.5 MG) to get the number of billing units, then round per your payer's policy. The calculator on this page converts a dose into billing units and projects a full course.
How much does Medicare pay for J8610?
The Medicare Part B payment limit is $0.154 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $0.151 per unit. Payment limits are revised quarterly.
Which NDCs bill under J8610?
20 NDCs currently map to J8610 in the CMS ASP NDC-HCPCS crosswalk. See the NDC crosswalk table above for each product, package, billing units and estimated reimbursement.
Does a crosswalk mean J8610 is covered?
No. An NDC-to-HCPCS crosswalk and a published payment limit do not guarantee coverage or payment. Coverage depends on the payer, the diagnosis and the site of care — always verify the current policy before billing.
For professional billing reference only — verify against the current CMS files before submitting claims.