METHOTREXATE J Code: J8610
Methotrexate; oral, 2.5 mg
Q4 2026 Medicare Payment Limit for J8610, effective October 1, 2026: $0.157 per HCPCS billing unit, up 1.9% from $0.154. From CMS's final file.
Drug & Product Overview
About METHOTREXATE
Methotrexate is a medication aligned to the HCPCS J Code: J8610 for billing, pricing, and reimbursement purposes in the United States. This Oncology medication is administered via the oral route and manufactured by multiple companies.
According to CMS Drug Use Information: Methotrexate is used to treat certain types of cancer (such as acute lymphoblastic leukemia, non-Hodgkin's lymphoma), severe psoriasis that has not responded to other treatments, or rheumatoid arthritis. It may also be used to treat a certain type of arthritis in children (polyarticular juvenile idiopathic arthritis - pJIA). Methotrexate belongs to a class of drugs known as antimetabolites. It works by slowing or stopping the growth of cancer cells and blocking the immune system from attacking healthy tissue. Early treatment of rheumatoid arthritis with methotrexate helps to reduce further joint damage and to preserve joint function.
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. Showing 5 of 23 NDCs — log in for the full crosswalk.
| NDC Code | Drug | Manufacturer | Billing Units / Pkg | Package Size |
|---|---|---|---|---|
| 00054-4550-25 | Methotrexate Sodium | Hikma Pharmaceuticals USA Inc. | 100 | 2.5 MG |
| 00378-0014-01 | Methotrexate | Mylan Pharmaceuticals Inc. | 100 | 2.5 MG |
| 00555-0572-02 | Methotrexate | Teva Pharmaceuticals USA, Inc. | 100 | 2.5 MG |
| 00904-7141-10 | Methotrexate | Major Pharmaceuticals | 20 | 2.5 MG |
| 16729-0486-01 | Methotrexate | Accord Healthcare Inc. | 100 | 2.5 MG |
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| •••••-••••-•• Log in to view | METHOTREXATE | •••••••••••• Log in to view | •••• Log in to view | ••• •• / • •• Log in to view |
METHOTREXATE Pricing & Reimbursement
National median reimbursement across major commercial payers.
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Login to use the calculator →Methotrexate 505(b)(2) Information:
METHOTREXATE 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 |
|---|---|
| 96401 | Chemotherapy administration, subcutaneous or intramuscular; non-hormonal anti-neoplastic |
| 96372 | Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intramuscular |
| 96450 Login for More | Chemotherapy administration, into CNS (eg, intrathecal), requiring and including spinal puncture Login for More |
CMS does not include Methotrexate (J8610) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J8610. Wastage billing guide →
METHOTREXATE Medically Unlikely Edits (MUE)
The most billing units of J8610 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 2.5 mg. The limit is different in the office and the hospital. Use the one for your setting.
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 →
METHOTREXATE Clinical Information
Indications and drug classification.
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.
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Frequently Asked Questions
Is there an available Methotrexate billing and coding guide?
Are there any available Methotrexate patient assistance programs?
Where can I find Methotrexate prescribing information?
Where can I find Methotrexate side effect information?
Does billing METHOTREXATE require JZ/JW wastage modifiers?
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