Home › Drug Codes › J Codes › J0120 · TETRACYCLINE HCL
Updated July 1st, 2026

TETRACYCLINE HCL J Code: J0120

Injection, tetracycline, up to 250 mg

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Medicare Payment Limit ?
Not published
CMS publishes none for Q3 2026
APC Payment Limit ?
Not published
CMS publishes none for Q3 2026
ASP ?
No current ASP
Not available for Q3 2026
WAC · AWP ?
$•••.••
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NDCs Crosswalked ?
—
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Drug & Product Overview

HCPCS Descriptor Injection, tetracycline, up to 250 mg
HCPCS Added Date January 1, 1986
Manufacturer Multiple Manufacturers
Generic Status Single-Source; Branded

About TETRACYCLINE HCL

Tetracycline HCL is a medication aligned to the HCPCS J Code: J0120 for billing, pricing, and reimbursement purposes in the United States. It is an Antibiotic drug manufactured by multiple companies.

Manufacturers, reach out to us to add more information.

NDC Code Information

No NDC packages are aligned to J0120 in publicly available CMS files.

NDC Code Drug Manufacturer Billing Units / Pkg Package Size
No public NDC alignments
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TETRACYCLINE HCL Pricing & Reimbursement

J0120 Private Payer Reimbursement
$11.99 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

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UnitedHealthcare, BlueCross BlueShield, Aetna, Cigna

TETRACYCLINE 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
Not on the CMS JW / JZ list

CMS does not include Tetracycline HCL (J0120) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J0120. Wastage billing guide →

TETRACYCLINE HCL Medically Unlikely Edits (MUE)

The most billing units of J0120 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 250 mg.

Practitioner Office & Hospital Outpatient
1 unit / day
= 250 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.

TETRACYCLINE 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.

Upper respiratory tract infections Lower respiratory tract infections Skin and soft tissue infections Rickettsial infections (Rocky Mountain spotted fever typhus group infections Q fever rickettsialpox) Psittacosis/ornithosis Chlamydia trachomatis infections (uncomplicated urethral, endocervical, or rectal infections inclusion conjunctivitis trachoma lymphogranuloma venereum) Granuloma inguinale Relapsing fever Bartonellosis Chancroid Tularemia Plague Cholera Brucellosis Infections due to Campylobacter fetus Intestinal amebiasis (adjunctive) Urinary tract infections Syphilis (when penicillin is contraindicated) Yaws (when penicillin is contraindicated) Vincent’s infection (when penicillin is contraindicated) Gonorrhea (when penicillin is contraindicated) Anthrax (when penicillin is contraindicated) Listeriosis (when penicillin is contraindicated) Actinomycosis (when penicillin is contraindicated) Clostridial infections (when penicillin is contraindicated) Severe acne (adjunctive)

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Frequently Asked Questions

Is there an available Tetracycline Hcl billing and coding guide?
We have not yet identified a manufacturer source of Tetracycline Hcl billing and coding information.
Are there any available Tetracycline Hcl patient assistance programs?
Our team did not identify a source for Tetracycline Hcl patient assistance information. Please reach out to our team if you feel that this is a mistake.
Where can I find Tetracycline Hcl prescribing information?
Our team is still working to identify a prescribing information source for TETRACYCLINE HCL
Where can I find Tetracycline Hcl side effect information?
Our team has not yet identified a source of side effects information for TETRACYCLINE HCL. Please check back in a few weeks.
Does billing TETRACYCLINE HCL require JZ/JW wastage modifiers?
CMS does not include TETRACYCLINE HCL (J0120) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J0120. For more information, visit the link below.

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