J9314 NDC Crosswalk, Billing Units, ASP Payment & Medicare Reimbursement

📋 J9314 summary

J9314 is a HCPCS Level II J-code used to bill pemetrexed (teva) not therapeutically equivalent to j9305, 10 mg, billed per 10 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 J9314: Pemetrexed(J9314)

Code J9314 Billing unit 10 MG Payment limit $10.986/unit NDC-Crosswalk 3 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 codeJ9314

DescriptorInjection, pemetrexed (teva) not therapeutically equivalent to j9305, 10 mg

Billing unit10 MG

Payment limit / unit$10.986

Est. ASP / unit$10.364 est.

Mapped NDCs3

Data periodQ3 2026

Last updated2026-08-20

💊 About Pemetrexed Injection DRUG GUIDE

Pemetrexed Injection is used for non-squamous non-small cell lung cancer (NSCLC) in several situations: as an initial treatment (combined with pembrolizumab and platinum chemotherapy, or with cisplatin alone), as a maintenance treatment after platinum-based chemotherapy, or as a single agent when the cancer has come back after prior chemotherapy.

It is not used for squamous cell non-small cell lung cancer.Pemetrexed Injection is also used, in combination with cisplatin, for the initial treatment of malignant pleural mesothelioma — a cancer of the lining of the lungs — in patients whose disease cannot be surgically removed or who are not good candidates for surgery.

Read the full Pemetrexed Injection drug guide →

Clinical overview from our editorial drug guide for Pemetrexed Injection. 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

$10.986

Est. ASP / unit

$10.364 est.

Est. after 2% sequester

$10.766

HCPCS dosage

10 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 descriptionInjection, pemetrexed (teva) not therapeutically equivalent to j9305, 10 mg

CoverageC — Carrier/MAC judgment

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 date2023-01-01

Date added2023-01-01

Source: CMS HCPCS Level II code file (imported via admin).

🧮 Dosing & billing-units calculator HCPCS UNITS

One billing unit of J9314 = 10 mg. Enter a regimen to convert dose → billing units and project a full course.

Dose per administration (mg) Frequency — every days Number of doses NDC / package billed (optional)

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 J9314 WITH EST. MEDICARE PAY

3 NDCs map to J9314. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($10.986/unit) × that package's bill units.

NDC (11-digit)	Drug	Labeler	Package	Strength	Bill units	Est. pay / pkg	NADAC / unit	Status	Source
00480-4514-01	Pemetrexed 25 mg/mL SOLUTION, CONCENTRATE	Teva	1 VIAL, SINGLE-DOSE in 1 CARTON (0480-4514...	25 mg/mL	50	$549.30	—	● Active	CMS ASP
00480-4515-01	Pemetrexed 25 mg/mL SOLUTION, CONCENTRATE	Teva	1 VIAL, SINGLE-DOSE in 1 CARTON (0480-4515...	25 mg/mL	100	$1,098.60	—	● Active	CMS ASP
00480-4516-01	Pemetrexed 25 mg/mL SOLUTION, CONCENTRATE	Teva	1 VIAL, SINGLE-DOSE in 1 CARTON (0480-4516...	25 mg/mL	10	$109.86	—	● Active	CMS ASP

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.

⚠️ Don't confuse J9314 with… RELATED CODES

Adjacent HCPCS codes that share an ingredient or formulation with J9314. Billing units and payment limits differ — confirm the exact code, strength and form before billing.

Code	Descriptor	Billing unit	Payment limit / unit	How it differs from J9314
J9304	Inj. pemetrexed, 10 mg	10 MG	$7.994	Related ingredient or formulation — confirm strength, form and billing unit before substituting.
J9305	Inj. pemetrexed nos 10mg	10 MG	$6.952	Related ingredient or formulation — confirm strength, form and billing unit before substituting.
J9324	Inj, pemrydi rtu, 10 mg	10 MG	$67.935	Related ingredient or formulation — confirm strength, form and billing unit before substituting.
J9292	PEMETREXED DIPOTASSIUM	10 MG	$73.670	Related ingredient or formulation — confirm strength, form and billing unit before substituting.
J9294	Inj pemetrexed, hospira 10mg	10 MG	$2.943	Related ingredient or formulation — confirm strength, form and billing unit before substituting.
J9323	Inj pemetrexed ditromethamin	—	—	Related ingredient or formulation — confirm strength, form and billing unit before substituting.

Related codes matched on shared ingredient (CMS Medicare Part B Spending feed). Billing units and payment limits from the CMS ASP Pricing File. Always verify the precise HCPCS code for the product and strength administered.

📊 Medicare utilization & spend CMS · PART B · 2026 (Q1)

Period

Total Part B spend

$54.9K

Claims

37

Beneficiaries

22

Spend / beneficiary

$2,493.36

Spend / claim

$1,482.54

Trend by period

Where J9314 ranks among Part B drugs · 2026 (Q1) · neighbors ±5

Total spending — #603 of 824

#598 INTEGRA MATRIX** Q4108 $61.9K #599 ABIO XPL ABIO XPL HY... Q4355 $61.8K #600 SODIUM CHLORIDE(J704... J7040 $60.2K #601 FENTANYL CITRATE J3010 $57.1K #602 LEVOTHYROXINE SODIUM... J0651 $55.4K #603 PEMETREXED(J9314) J9314 $54.9K #604 DILAUDID* J1171 $54.5K #605 PROGRAF(J7521) J7521 $53.4K #606 ARSENIC TRIOXIDE* J9017 $53K #607 CLADRIBINE J9065 $50.6K #608 ZALTRAP J9400 $47.2K

Total claims — #726 of 824

#721 CHLOROTHIAZIDE SODIU... J1205 38 #722 FLUCONAZOLE-NACL J1450 38 #723 VANCOMYCIN HCL(J3374... J3374 38 #724 PERSERIS J2798 37 #725 XYNTHA SOLOFUSE* J7185 37 #726 PEMETREXED(J9314) J9314 37 #727 TYZAVAN* J3375 35 #728 HEPZATO J9248 35 #729 HYCAMTIN J8705 34 #730 LAMZEDE J0217 33 #731 ZEMDRI J0291 33

Full breakdown by period (2)

Period	Total spend	Beneficiaries	Claims	$/beneficiary	$/claim
2026 (Q1)	$54.9K	22	37	$2,493.36	$1,482.54
2025 (Q1-Q4)	$244K	94	327	$2,595.98	$746.24

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

$10.8K

Medicare paid

$8.7K

Submitted services

1,448

Denial rate

18.0%

Allowed / service

$9.09

Submitted charges

$68.9K

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.

🗃️ 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

3 NDCs mapped

NADAC acquisition cost

CMS National Average Drug Acquisition Cost (weekly)

Not 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.

❓ J9314 billing FAQ

What is HCPCS code J9314?

J9314 is a HCPCS Level II J-code used to bill Injection, pemetrexed (teva) not therapeutically equivalent to j9305, 10 mg under Medicare Part B and most medical (not pharmacy) benefits.

What is the billing unit for J9314?

One unit of J9314 represents 10 MG. Report the number of units equal to the dose administered divided by 10 MG.

How many units of J9314 should I bill?

Divide the dose administered by the code's unit size (10 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 J9314?

The Medicare Part B payment limit is $10.986 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $10.766 per unit. Payment limits are revised quarterly.

Which NDCs bill under J9314?

3 NDCs currently map to J9314 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 J9314 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.

J9314 – Injection, pemetrexed (teva) not therapeutically equivalent to j9305, 10 · NDC Crosswalk & Billing Units