Home › Drug Codes › J Codes › J1230 · METHADONE HCL
Updated July 1st, 2026

METHADONE HCL J Code: J1230

Injection, methadone hcl, up to 10 mg

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Q4 2026 Medicare Payment Limit for J1230, effective October 1, 2026: $10.498 per HCPCS billing unit, down 17.4% from $12.707. From CMS's final file.

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Medicare Payment Limit ?
$12.707
/ HCPCS billing unit · Q3 2026
APC Payment Limit ?
Not published
CMS publishes none for Q3 2026
ASP ?
$•••.••
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WAC · AWP ?
$•••.••
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NDCs Crosswalked ?
4
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Drug & Product Overview

HCPCS Descriptor Injection, methadone hcl, up to 10 mg
HCPCS Added Date January 1, 1982
Manufacturer Multiple Manufacturers
Route of Administration Intramuscular, Intravenous, Subcutaneous
Generic Status Multi-Source; Generic
Dosage Type Multi-Dose
Dosage Form Injection | Injection, Solution

About METHADONE HCL

Methadone HCL is a medication aligned to the HCPCS J Code: J1230 for billing, pricing, and reimbursement purposes in the United States. This Opioid Analgesic medication is administered via the intramuscular, intravenous, or subcutaneous routes and manufactured by multiple companies.

According to CMS Drug Use Information: This medication is used to treat moderate to severe pain. Methadone is an opioid medication. It acts on certain centers in the brain to relieve pain. This medication is also used to treat opioid use disorder as part of an approved treatment program. It helps prevent withdrawal symptoms caused by stopping other opioids.

Disclaimer: This is a summary and does not contain all possible information about this product. For complete information about this product or your specific health needs, ask your healthcare professional.

NDC Code Information

Based on publicly available CMS files. The list of NDCs below is not exhaustive.

NDC Code Drug Manufacturer Billing Units / Pkg Package Size
00641-6266-01 Methadone Hydrochloride Hikma Pharmaceuticals USA Inc. 20 200 MG / 20 ML
51991-0002-98 Methadone Hydrochloride Breckenridge Pharmaceutical Inc 20 200 MG / 20 ML
67457-0217-20 Methadone Hydrochloride Mylan Institutional LLC 20 200 MG / 20 ML
81298-7500-01 Methadone Hydrochloride Long Grove Pharmaceuticals, LLC 20 200 MG / 20 ML
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METHADONE HCL Pricing & Reimbursement

J1230 Private Payer Reimbursement
$18.07 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

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UnitedHealthcare, BlueCross BlueShield, Aetna, Cigna

Historical Graphing and Billing Calculator

per HCPCS unit
As of Q3 2026

METHADONE HCL CPT Administration Codes

The below list of CPT codes is intended for informational purposes only and may not be exhaustive. CPT® codes and descriptions are copyright American Medical Association (AMA). All rights reserved.

CPT Code Description
96372 Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intramuscular
96374 Therapeutic, prophylactic, or diagnostic injection (specify substance or drug), IV push, single, or initial substance/drug
Not on the CMS JW / JZ list

CMS does not include Methadone HCL (J1230) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J1230. Wastage billing guide →

METHADONE HCL Medically Unlikely Edits (MUE)

The most billing units of J1230 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 10 mg. The limit is different in the office and the hospital. Use the one for your setting.

Practitioner Office
3 units / day
= 30 mg per day
Hospital Outpatient
5 units / day
= 50 mg per day

MAI 3 · Date of Service Edit: Clinical. Per-day limit based on clinical expectations; excess units are denied but may be appealed with documentation of medical necessity. See all MUE limits →

mg Enter a dose to see how many billing units it is and whether it is under the limit.

METHADONE HCL Clinical Information

Indications and drug classification.

Treated Diseases & Conditions

This list of indications is not exhaustive and may be subject to errors. The information on BuyandBill.com is intended for informational purposes only and should not be used for medical advice.

Opioid dependence Severe and persistent pain Severe and persistent pain requiring an opioid analgesic opioid dependence severe and persistent pain
Drug Class
Full Opioid Agonists [MoA]Opioid Agonist [EPC]

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Frequently Asked Questions

Is there an available Methadone Hcl billing and coding guide?
We have not yet identified a manufacturer source of Methadone Hcl billing and coding information.
Are there any available Methadone Hcl patient assistance programs?
Our team did not identify a source for Methadone Hcl patient assistance information. Please reach out to our team if you feel that this is a mistake.
Where can I find Methadone Hcl prescribing information?
METHADONE HCL prescribing information can be found at the link below: Visit Here →
Where can I find Methadone Hcl side effect information?
Information regarding METHADONE HCL's side effects can be found at MedlinePlus Visit Here →
Does billing METHADONE HCL require JZ/JW wastage modifiers?
CMS does not include METHADONE HCL (J1230) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J1230. For more information, visit the link below.

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