HCPCS drug code · CMS crosswalk
Methadone HCl J-Code / HCPCS Code
In short
Methadone HCl is billed under HCPCS J1230 — Injection, methadone hcl, up to 10 mg. One billing unit is 10 mg. CMS's crosswalk lists 4 Methadone HCl NDCs under this code.
Reference
- J1230
- Injection, methadone hcl, up to 10 mgBilling unit: 10 mg
- Labelers
- Breckenridge Pharmaceutical, Inc.; Hikma Pharmaceuticals USA Inc.; Long Grove Pharmaceuticals, LLC; Mylan Institutional LLC
Medicare Part B payment limit
CMS ASP filePayment limit per unit$10.498
Per10 mg
Coinsurance20%
Effective October 1, 2026 through December 31, 2026. Payment allowance limits subject to the ASP methodology are based on 2Q26 ASP data. A payment limit is not a coverage decision; the Medicare contractor decides coverage. CMS ASP pricing files
Methadone HCl units and claim line
Enter the dose given to get the J1230 units and the NDC line for the CMS-1500 and the 837P.
Enter the dose given to build the claim line.
Methadone HCl NDCs and billing units
From CMS’s ASP NDC–HCPCS crosswalk, effective October 1, 2026 through December 31, 2026. Billing units per package are CMS’s figures for the code’s unit.
| NDC (11-digit) | HCPCS | Labeler | Package | Billing units per package |
|---|---|---|---|---|
| 67457-0217-20 | J1230 | Mylan Institutional LLC | 20 | 20 |
| 00641-6266-01 | J1230 | Hikma Pharmaceuticals USA Inc. | 20 | 20 |
| 51991-0002-98 | J1230 | Breckenridge Pharmaceutical, Inc. | 20 | 20 |
| 81298-7500-01 | J1230 | Long Grove Pharmaceuticals, LLC | 20 | 20 |
Methadone HCl: common questions
- What is the J-code for Methadone HCl?
- Methadone HCl is billed under HCPCS J1230 — Injection, methadone hcl, up to 10 mg. One billing unit is 10 mg. CMS's crosswalk lists 4 Methadone HCl NDCs under this code.
- How many J1230 billing units are in a package of Methadone HCl?
- CMS lists 20 billing units per package, depending on the NDC, where one unit is 10 mg. Units to report are based on the dose given, not the package.
- Is J1230 a CPT code?
- No. J1230 is a HCPCS Level II code from CMS for the drug itself. Giving it, for example by injection or infusion, is usually reported with a separate CPT administration code.