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HCPCS J8501 · Level II · Part B drug

HCPCS J8501: Aprepitant, oral, 5 mg

Reviewed by QuickIntell RCM Editorial Team · Last reviewed

Data effective
Data currency: ASP payment limits October 2026 (effective October 1, 2026); MUE and NCCI edits 2026 Q4 (effective October 1, 2026); OPPS Addendum B July 2026 (effective July 1, 2026). Next CMS release: January 1, 2027 (ASP, MUE, NCCI and OPPS quarterly updates).

Key facts for J8501

Billing unit
5 MG
Oral aprepitant
ASP payment limit
$2.511
October 2026; -18.2% vs July 2026
Practitioner MUE
0
MAI 3
OPPS status
SI N
NCCI exposure
no PTP pairs
Coverage articles
0
none list this code

TL;DR

HCPCS J8501 is the Level II code for Aprepitant, oral, 5 mg, billed per 5 MG. The Medicare Part B ASP payment limit for October 2026 is $2.511 per billing unit, down 18.2% from July 2026. The practitioner MUE allows up to 0 units per date of service (MAI 3). Under OPPS it carries status indicator N. Oral drugs under Part B are payable only in the specific statutory categories (for example oral anticancer or antiemetic drugs with a self-administration exception), so the diagnosis and the regimen must match that category. The ASP crosswalk maps 27 NDCs to it, sold as Emend, Aprepitant by Merck Sharp & Dohme LLC, Sandoz Inc., Torrent Pharmaceuticals Limited. No current Billing and Coding Article lists J8501, so coverage follows the FDA label, compendia and any applicable NCD.

Medicare Part B payment limit (ASP)

CMS sets the Part B payment limit for J8501 at $2.511 per 5 MG for October 2026, derived from manufacturer average sales price plus 6%, compared with $3.069 in July 2026. Beneficiary coinsurance is 20%.

ASP payment limits for J8501
QuarterPayment limitPerCoinsurance
October 2026$2.5115 MG20%
July 2026$3.0695 MG—
Source: CMS Medicare Part B Drug Payment Limit File. Commercial and Medicaid payers set their own rates.

NDC to HCPCS billing-unit conversion

The October 2026 ASP crosswalk maps 27 NDCs from 5 labelers to J8501. Report the NDC in the claim's drug segment and bill the number of J8501 units that equals the quantity administered divided by 5 MG; the last column gives units per full package.

NDCs that crosswalk to J8501
NDCDrug nameLabelerPackage sizeBilling units / package
00006-0461-02EmendMerck Sharp & Dohme LLC1 × 232
00006-3066-03EmendMerck Sharp & Dohme LLC1 × 125
00006-3862-03EmendMerck Sharp & Dohme LLC1 × 357
00781-2321-06AprepitantSandoz Inc.1 × 18
00781-2321-51AprepitantSandoz Inc.5 × 140
00781-2322-46AprepitantSandoz Inc.2 × 132
00781-2322-68AprepitantSandoz Inc.6 × 196
00781-2323-68AprepitantSandoz Inc.6 × 1150
00781-4063-36AprepitantSandoz Inc.3 × 157
13668-0591-81AprepitantTorrent Pharmaceuticals Limited1 × 18
13668-0591-82AprepitantTorrent Pharmaceuticals Limited5 × 140
13668-0592-84AprepitantTorrent Pharmaceuticals Limited2 × 132
13668-0592-86AprepitantTorrent Pharmaceuticals Limited6 × 196
13668-0593-86AprepitantTorrent Pharmaceuticals Limited6 × 1150
13668-0594-87AprepitantTorrent Pharmaceuticals Limited3 × 157
68001-0666-01AprepitantBluePoint Laboratories1 × 18
68001-0666-17AprepitantBluePoint Laboratories5 × 140
68001-0667-01AprepitantBluePoint Laboratories2 × 132
68001-0667-19AprepitantBluePoint Laboratories6 × 196
68001-0668-19AprepitantBluePoint Laboratories6 × 1150
68001-0669-15AprepitantBluePoint Laboratories3 × 157
68462-0112-33AprepitantGlenmark Pharmaceuticals Inc., USA3 × 157
68462-0583-40AprepitantGlenmark Pharmaceuticals Inc., USA1 × 18
68462-0583-85AprepitantGlenmark Pharmaceuticals Inc., USA5 × 140
68462-0584-58AprepitantGlenmark Pharmaceuticals Inc., USA2 × 132
68462-0584-76AprepitantGlenmark Pharmaceuticals Inc., USA6 × 196
68462-0585-76AprepitantGlenmark Pharmaceuticals Inc., USA6 × 1150

Medically Unlikely Edits (MUE)

CMS publishes 3 MUE values for J8501. For practitioners the limit is 0 units per date of service with adjudication indicator 3, a date-of-service clinical edit: units above the limit deny but can be paid on appeal with documentation that the quantity was medically reasonable.

MUE values for J8501 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services03 Date of Service Edit: ClinicalOral Medication; Not Payable
Facility outpatient hospital573 Date of Service Edit: ClinicalCMS Policy
DME supplier573 Date of Service Edit: ClinicalCMS Policy

NCCI edits and add-on relationships

No active practitioner PTP pair lists J8501 as a column-1 or column-2 code in v323r0. Drug supply codes are rarely bundled; the administration codes billed with them are where PTP edits usually apply.

J8501 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.

Medicare coverage articles

No current Billing and Coding Article lists J8501 in its HCPCS table. Coverage then follows the drug's FDA label, compendia and any National Coverage Determination; check the Medicare Coverage Database before administering off-label.

Hospital outpatient (OPPS) status

In the July 2026 OPPS Addendum B, J8501 carries status indicator N. Status N means payment is packaged into the associated procedure and no separate OPPS payment is made.

Common denials for J8501 and how to prevent them

CARC 16 · M119

NDC missing, invalid or not matched to the HCPCS code

CARC 151 · N362

units billed exceed the MUE for the date of service

CARC 50 · N115

diagnosis not covered by the applicable coverage article or LCD

How QuickIntell checks J8501 before the claim leaves

QuickCode validates the NDC-to-unit conversion against the current ASP crosswalk, checks units against every published MUE setting and flags PTP and add-on conflicts on the same claim. QuickRCM routes CARC 16, 151 and 50 denials on drug lines with the matching coverage article attached so the appeal starts with evidence.

Explore QuickCodeExplore QuickRCMBook a demo

Frequently asked questions — HCPCS J8501

What does HCPCS code J8501 describe?

J8501 is defined by CMS as "Aprepitant, oral, 5 mg". Each billing unit represents 5 MG, so the units reported on the claim must equal the dose administered divided by that unit.

What is the Medicare reimbursement for J8501 in October 2026?

The ASP-based payment limit is $2.511 per 5 MG, with 20% beneficiary coinsurance. Medicare Administrative Contractors apply this limit; commercial payers use their own fee schedules. The July 2026 limit was $3.069.

How many units of J8501 can be billed per day?

The practitioner Medically Unlikely Edit is 0 units per date of service with adjudication indicator 3 (3 Date of Service Edit: Clinical). MAI 3 edits can be appealed with documentation that the units were medically reasonable. CMS cites "Oral Medication; Not Payable" as the rationale.

Which NDCs map to J8501?

The October 2026 ASP crosswalk lists 27 NDCs from 5 labelers: Emend (Merck Sharp & Dohme LLC); Aprepitant (Sandoz Inc.); Aprepitant (Torrent Pharmaceuticals Limited); Aprepitant (BluePoint Laboratories). For example NDC 00006-0461-02 is a 1 package equal to 32 billing units. The crosswalk's billing-units-per-package figure converts each package into J8501 units.

Does J8501 have NCCI bundling edits?

No active practitioner PTP pairs list J8501 as a column-1 or column-2 code in the v323r0 release. Unit limits (MUE) and medical-necessity coverage rules still apply.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-01. Verify against the primary file before billing or contracting decisions.

Disclaimer

This page is an operational reference compiled from CMS publications: the Medicare Part B drug payment limit and NDC crosswalk files, NCCI MUE and add-on edit tables, aggregate PTP statistics, OPPS Addendum B and the Medicare Coverage Database. Payment limits are Medicare national amounts; commercial and Medicaid payers differ. CPT codes are shown as numbers only; CPT descriptors are copyright AMA. Nothing here is legal, clinical or billing advice.