J9255 — Injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg
J9255 is a HCPCS Level II code for injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg. It belongs to the Drugs Administered Other Than Oral Method section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Special coverage instructions apply
There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusE
Excluded from the physician fee schedule by regulation. Payment, where it exists, comes from another fee schedule (drugs via ASP, supplies via DMEPOS, and so on).
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
The CMS record for J9255
- Long descriptor
- Injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg
- Short descriptor
- Inj, methotrexate (accord)
- Added
- January 1, 2024
- BETOS
- O1E
- Pricing indicator
- 51 — Other
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Drugs.
Codes adjacent to J9255
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If J9255 is not quite right, the correct code is very often within a few positions of it.
- J9230Injection, mechlorethamine hydrochloride, (nitrogen mustard), 10 mg
- J9232Injection, docetaxel (hospira), not therapeutically equivalent to j9171, 1 mg
- J9245Injection, melphalan hydrochloride, not otherwise specified, 50 mg
- J9246Injection, melphalan (evomela), 1 mg
- J9247Injection, melphalan flufenamide, 1mgterminated
- J9248Injection, melphalan (hepzato), 1 mg
- J9249Injection, melphalan (apotex), 1 mg
- J9250Methotrexate sodium, 5 mgterminated
- J9256Injection, nipocalimab-aahu, 3 mg
- J9258Injection, paclitaxel protein-bound particles (teva), not therapeutically equivalent to j9264, 1 mgterminated
- J9259Injection, paclitaxel protein-bound particles (american regent), not therapeutically equivalent to j9264, 1 mgterminated
- J9260Injection, methotrexate sodium, 50 mg
- J9261Injection, nelarabine, 50 mg
- J9262Injection, omacetaxine mepesuccinate, 0.01 mg
- J9263Injection, oxaliplatin, 0.5 mg
- J9264Injection, paclitaxel protein-bound particles, 1 mg
Questions about J9255
What is HCPCS code J9255?
J9255 is a HCPCS Level II code for injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg. It sits in the Drugs Administered Other Than Oral Method section.
Does Medicare cover J9255?
The CMS HCPCS file marks J9255 as "Special coverage instructions apply". There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
How is J9255 paid under the physician fee schedule?
J9255 carries PFS status code E. Excluded from the physician fee schedule by regulation. Payment, where it exists, comes from another fee schedule (drugs via ASP, supplies via DMEPOS, and so on).