Key facts for J8540
- Billing unit
- 0.25 MG
- Oral dexamethasone
- ASP payment limit
- $0.022
- October 2026; -15.4% 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 J8540 is the Level II code for Dexamethasone, oral, 0.25 mg, billed per 0.25 MG. The Medicare Part B ASP payment limit for October 2026 is $0.022 per billing unit, down 15.4% 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 49 NDCs to it, sold as Dexamethasone Intensol, Dexamethasone by Hikma Pharmaceuticals USA Inc., Major Pharmaceuticals, PD-Rx Pharmaceuticals, Inc.. No current Billing and Coding Article lists J8540, 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 J8540 at $0.022 per 0.25 MG for October 2026, derived from manufacturer average sales price plus 6%, compared with $0.026 in July 2026. Beneficiary coinsurance is 20%.
| Quarter | Payment limit | Per | Coinsurance |
|---|---|---|---|
| October 2026 | $0.022 | 0.25 MG | 20% |
| July 2026 | $0.026 | 0.25 MG | — |
NDC to HCPCS billing-unit conversion
The October 2026 ASP crosswalk maps 49 NDCs from 10 labelers to J8540. Report the NDC in the claim's drug segment and bill the number of J8540 units that equals the quantity administered divided by 0.25 MG; the last column gives units per full package.
| NDC | Drug name | Labeler | Package size | Billing units / package |
|---|---|---|---|---|
| 00054-3176-44 | Dexamethasone Intensol | Hikma Pharmaceuticals USA Inc. | 30 × 1 | 120 |
| 00054-3177-63 | Dexamethasone | Hikma Pharmaceuticals USA Inc. | 500 × 1 | 200 |
| 00054-4184-25 | Dexamethasone | Hikma Pharmaceuticals USA Inc. | 100 × 1 | 1600 |
| 00054-8175-25 | Dexamethasone | Hikma Pharmaceuticals USA Inc. | 100 × 1 | 1600 |
| 00054-8180-25 | Dexamethasone | Hikma Pharmaceuticals USA Inc. | 100 × 1 | 300 |
| 00054-8181-25 | Dexamethasone | Hikma Pharmaceuticals USA Inc. | 100 × 1 | 600 |
| 00904-7266-61 | Dexamethasone | Major Pharmaceuticals | 100 × 1 | 1600 |
| 00904-7267-61 | Dexamethasone | Major Pharmaceuticals | 100 × 1 | 2400 |
| 00904-7444-61 | Dexamethasone | Major Pharmaceuticals | 100 × 1 | 800 |
| 43063-0266-07 | Dexamethasone | PD-Rx Pharmaceuticals, Inc. | 7 × 1 | 56 |
| 50090-0088-04 | Dexamethasone | A-S Medication Solutions | 6 × 1 | 96 |
| 50090-0089-00 | Dexamethasone | A-S Medication Solutions | 28 × 1 | 448 |
| 50090-6151-04 | Dexamethasone | A-S Medication Solutions | 6 × 1 | 96 |
| 50090-6152-00 | Dexamethasone | A-S Medication Solutions | 28 × 1 | 448 |
| 55289-0582-04 | Dexamethasone | PD-Rx Pharmaceuticals, Inc. | 4 × 1 | 64 |
| 55289-0582-06 | Dexamethasone | PD-Rx Pharmaceuticals, Inc. | 6 × 1 | 96 |
| 55289-0582-28 | Dexamethasone | PD-Rx Pharmaceuticals, Inc. | 28 × 1 | 448 |
| 55289-0903-12 | Dexamethasone | PD-Rx Pharmaceuticals, Inc. | 12 × 1 | 36 |
| 60505-6249-01 | Dexamethasone | Apotex Corp | 100 × 1 | 200 |
| 60505-6250-01 | Dexamethasone | Apotex Corp | 100 × 1 | 300 |
| 60505-6251-01 | Dexamethasone | Apotex Corp | 100 × 1 | 400 |
| 60505-6252-01 | Dexamethasone | Apotex Corp | 100 × 1 | 600 |
| 60505-6253-01 | Dexamethasone | Apotex Corp | 100 × 1 | 800 |
| 60505-6254-01 | Dexamethasone | Apotex Corp | 100 × 1 | 1600 |
| 60505-6255-01 | Dexamethasone | Apotex Corp | 100 × 1 | 2400 |
| 60687-0718-01 | Dexamethasone | American Health Packaging | 100 × 1 | 1600 |
| 60687-0729-01 | Dexamethasone | American Health Packaging | 100 × 1 | 2400 |
| 60687-0773-01 | Dexamethasone | American Health Packaging | 100 × 1 | 800 |
| 66993-0730-02 | Dexamethasone | Prasco Laboratories | 100 × 1 | 1600 |
| 66993-0730-80 | Dexamethasone | Prasco Laboratories | 100 × 1 | 1600 |
| 68788-4113-01 | Dexamethasone | Preferred Pharmaceuticals Inc | 12 × 1 | 192 |
| 68788-7267-02 | Dexamethasone | Preferred Pharmaceuticals Inc | 21 × 1 | 63 |
| 68788-7267-03 | Dexamethasone | Preferred Pharmaceuticals Inc | 30 × 1 | 90 |
| 68788-8223-01 | Dexamethasone | Preferred Pharmaceuticals Inc | 12 × 1 | 192 |
| 68788-8223-03 | Dexamethasone | Preferred Pharmaceuticals Inc | 30 × 1 | 480 |
| 68788-8223-06 | Dexamethasone | Preferred Pharmaceuticals Inc | 6 × 1 | 96 |
| 68788-8467-01 | Dexamethasone | Preferred Pharmaceuticals Inc | 12 × 1 | 192 |
| 68788-8467-03 | Dexamethasone | Preferred Pharmaceuticals Inc | 30 × 1 | 480 |
| 68788-8763-03 | Dexamethasone | Preferred Pharmaceuticals Inc | 30 × 1 | 90 |
| 68788-8824-03 | Dexamethasone | Preferred Pharmaceuticals Inc | 30 × 1 | 480 |
| 70954-0398-10 | Dexamethasone | ANI Pharmaceuticals, Inc. | 100 × 1 | 200 |
| 70954-0399-10 | Dexamethasone | ANI Pharmaceuticals, Inc. | 100 × 1 | 300 |
| 72603-0187-01 | Dexamethasone | Northstar RxLLC | 100 × 1 | 600 |
| 72603-0188-01 | Dexamethasone | Northstar RxLLC | 100 × 1 | 800 |
| 72603-0189-01 | Dexamethasone | Northstar RxLLC | 100 × 1 | 1600 |
| 72603-0190-01 | Dexamethasone | Northstar RxLLC | 100 × 1 | 2400 |
| 72603-0212-01 | Dexamethasone | Northstar RxLLC | 100 × 1 | 200 |
| 72603-0213-01 | Dexamethasone | Northstar RxLLC | 100 × 1 | 300 |
| 72789-0501-20 | Dexamethasone | PD-Rx Pharmaceuticals, Inc. | 20 × 1 | 60 |
Medically Unlikely Edits (MUE)
CMS publishes 3 MUE values for J8540. 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.
| Setting | MUE (units/DOS) | MAI | CMS rationale |
|---|---|---|---|
| Practitioner services | 0 | 3 Date of Service Edit: Clinical | Oral Medication; Not Payable |
| Facility outpatient hospital | 80 | 3 Date of Service Edit: Clinical | Clinical: Data |
| DME supplier | 216 | 3 Date of Service Edit: Clinical | Clinical: Society Comment |
NCCI edits and add-on relationships
No active practitioner PTP pair lists J8540 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.
J8540 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 J8540 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, J8540 carries status indicator N. Status N means payment is packaged into the associated procedure and no separate OPPS payment is made.
Common denials for J8540 and how to prevent them
How QuickIntell checks J8540 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.
Frequently asked questions — HCPCS J8540
What does HCPCS code J8540 describe?
J8540 is defined by CMS as "Dexamethasone, oral, 0.25 mg". Each billing unit represents 0.25 MG, so the units reported on the claim must equal the dose administered divided by that unit.
What is the Medicare reimbursement for J8540 in October 2026?
The ASP-based payment limit is $0.022 per 0.25 MG, with 20% beneficiary coinsurance. Medicare Administrative Contractors apply this limit; commercial payers use their own fee schedules. The July 2026 limit was $0.026.
How many units of J8540 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 J8540?
The October 2026 ASP crosswalk lists 49 NDCs from 10 labelers: Dexamethasone Intensol (Hikma Pharmaceuticals USA Inc.); Dexamethasone (Hikma Pharmaceuticals USA Inc.); Dexamethasone (Major Pharmaceuticals); Dexamethasone (PD-Rx Pharmaceuticals, Inc.). For example NDC 00054-3176-44 is a 30 package equal to 120 billing units. The crosswalk's billing-units-per-package figure converts each package into J8540 units.
Does J8540 have NCCI bundling edits?
No active practitioner PTP pairs list J8540 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.
- HCPCS Level II alpha-numeric file, October 2026Version October 2026 · effective 2026-10-01 · file HCPC2026_OCT_ANWEB_09232026.txtSHA-256 c25240c63108756d…
- Medicare Part B Drug Payment Limit File, October 2026Version October 2026 · effective 2026-10-01 · file section 508 version of October 2026 Medicare Part B Payment Limit File 091626.csvSHA-256 508fba376a29e099…
- Medicare Part B Drug Payment Limit File, July 2026Version July 2026 · effective 2026-07-01 · file section 508 version of July 2026 Medicare Part B Payment Limit File updated 082026.csvSHA-256 13bb5b644b92b574…
- ASP NDC-HCPCS Crosswalk, October 2026Version October 2026 · effective 2026-10-01 · file section 508 version of October 2026 ASP NDC-HCPCS Crosswalk 091126.csvSHA-256 5cb78f0c2ee786ba…
- NCCI MUE table, practitioner services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_PractitionerServices_Eff_10-01-2026.csvSHA-256 ef038efaf902b7bd…
- NCCI MUE table, facility services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_OutpatientHospitalServices_Eff_10-01-2026.csvSHA-256 3af9f4e99cc587e2…
- NCCI MUE table, dme services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_DMESupplierServices_Eff_10-01-2026.csvSHA-256 6fa4fbba852f7b74…
- NCCI PTP edits, practitioner, v323r0 (four files)Version v323r0 (2026 Q4) · effective 2026-10-01 · file ccipra-v323r0-f1.TXTSHA-256 7793c0b6686c1e22…
- NCCI Add-On Code edits, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file AOC_V2026Q4-F-MCR.txtSHA-256 3c92860fb5001967…
- OPPS Addendum B, July 2026Version July 2026 · effective 2026-07-01 · file 2026 July Web Addendum B.07.13.26.csvSHA-256 e50a1fa958ed2bb2…
- Medicare Coverage Database, current Billing and Coding Articles exportVersion MCD release 2026-09-24 · effective 2026-09-20 · file article.csvSHA-256 f31932f1df3b4035…
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.