J8499: Prescription drug, oral, non chemotherapeutic, nos
J8499 is a HCPCS Level II code for prescription drug, oral, non chemotherapeutic, nos. It belongs to the Drugs Administered Other Than Oral Method section. Medicare does not pay it: see the coverage note below before you bill it.
Medicare coverage: Non-covered by Medicare
Medicare does not cover the item or service this code describes.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q4-Oct. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusN
Non-covered service. Medicare does not cover it.
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
Medically Unlikely Edits: units per day
The most units of J8499 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 0, never payable MAI 3: Date of Service Edit: Clinical · CMS Policy
- outpatient
- 0, never payable MAI 3: Date of Service Edit: Clinical · CMS Policy
- DME supplier
- 0, never payable MAI 3: Date of Service Edit: Clinical · CMS Policy
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute, no documentation overrides it. CMS MUE 2026Q4.
The CMS record for J8499
- Long descriptor
- Prescription drug, oral, non chemotherapeutic, nos
- Short descriptor
- Oral prescrip drug non chemo
- Added
- January 1, 1995
- BETOS
- O1E
- Pricing indicator
- 00: Not priced by Part B
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.
Service not separately priced by Part B, not covered, bundled into another service, or used by Part A only.
Codes adjacent to J8499
HCPCS has no hierarchy: related items simply sit next to each other in the numbering. If J8499 is not quite right, the correct code is very often within a few positions of it.
- J7683Triamcinolone, inhalation solution, compounded product, administered through dme, concentrated form, per milligram
- J7684Triamcinolone, inhalation solution, compounded product, administered through dme, unit dose form, per milligram
- J7685Tobramycin, inhalation solution, compounded product, administered through dme, unit dose form, per 300 milligrams
- J7686Treprostinil, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, 1.74 mg
- J7699Noc drugs, inhalation solution administered through dme
- J7799Noc drugs, other than inhalation drugs, administered through dme
- J7999Compounded drug, not otherwise classified
- J8498Antiemetic drug, rectal/suppository, not otherwise specified
- J8501Aprepitant, oral, 5 mg
- J8502Injection, aprepitant (aponvie), 1 mg
- J8510Busulfan; oral, 2 mg
- J8515Cabergoline, oral, 0.25 mg
- J8520Capecitabine, oral, 150 mgterminated
- J8521Capecitabine, oral, 500 mgterminated
- J8522Capecitabine, oral, 50 mg
- J8530Cyclophosphamide; oral, 25 mg