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HCPCS J8700 · Level II · Part B drug

HCPCS J8700: Temozolomide, 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 J8700

Billing unit
5 MG
Temozolomide
ASP payment limit
$0.208
October 2026; -51.1% 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 J8700 is the Level II code for Temozolomide, oral, 5 mg, billed per 5 MG. The Medicare Part B ASP payment limit for October 2026 is $0.208 per billing unit, down 51.1% 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 35 NDCs to it, sold as Temozolomide by Accord Healthcare Inc, Sun Pharmaceutical Global FZE., AvPAK. No current Billing and Coding Article lists J8700, 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 J8700 at $0.208 per 5 MG for October 2026, derived from manufacturer average sales price plus 6%, compared with $0.425 in July 2026. Beneficiary coinsurance is 20%.

ASP payment limits for J8700
QuarterPayment limitPerCoinsurance
October 2026$0.2085 MG20%
July 2026$0.4255 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 35 NDCs from 4 labelers to J8700. Report the NDC in the claim's drug segment and bill the number of J8700 units that equals the quantity administered divided by 5 MG; the last column gives units per full package.

NDCs that crosswalk to J8700
NDCDrug nameLabelerPackage sizeBilling units / package
16729-0048-53TemozolomideAccord Healthcare Inc5 × 15
16729-0048-54TemozolomideAccord Healthcare Inc14 × 114
16729-0049-53TemozolomideAccord Healthcare Inc5 × 120
16729-0049-54TemozolomideAccord Healthcare Inc14 × 156
16729-0050-53TemozolomideAccord Healthcare Inc5 × 1100
16729-0050-54TemozolomideAccord Healthcare Inc14 × 1280
16729-0051-53TemozolomideAccord Healthcare Inc5 × 1250
16729-0129-53TemozolomideAccord Healthcare Inc5 × 1140
16729-0129-54TemozolomideAccord Healthcare Inc14 × 1392
16729-0130-53TemozolomideAccord Healthcare Inc5 × 1180
16729-0130-54TemozolomideAccord Healthcare Inc14 × 1504
47335-0890-72TemozolomideSun Pharmaceutical Global FZE.15 × 115
47335-0890-74TemozolomideSun Pharmaceutical Global FZE.5 × 15
47335-0891-72TemozolomideSun Pharmaceutical Global FZE.15 × 160
47335-0891-74TemozolomideSun Pharmaceutical Global FZE.5 × 120
47335-0892-72TemozolomideSun Pharmaceutical Global FZE.15 × 1300
47335-0892-74TemozolomideSun Pharmaceutical Global FZE.5 × 1100
47335-0893-74TemozolomideSun Pharmaceutical Global FZE.5 × 1250
47335-0929-72TemozolomideSun Pharmaceutical Global FZE.15 × 1420
47335-0929-74TemozolomideSun Pharmaceutical Global FZE.5 × 1140
47335-0930-72TemozolomideSun Pharmaceutical Global FZE.15 × 1540
47335-0930-74TemozolomideSun Pharmaceutical Global FZE.5 × 1180
50268-0761-12TemozolomideAvPAK20 × 180
50268-0762-12TemozolomideAvPAK20 × 1400
65162-0801-14TemozolomideAmneal Pharmaceuticals, LLC14 × 114
65162-0801-51TemozolomideAmneal Pharmaceuticals, LLC5 × 15
65162-0802-14TemozolomideAmneal Pharmaceuticals, LLC14 × 156
65162-0802-51TemozolomideAmneal Pharmaceuticals, LLC5 × 120
65162-0803-14TemozolomideAmneal Pharmaceuticals, LLC14 × 1280
65162-0803-51TemozolomideAmneal Pharmaceuticals, LLC5 × 1100
65162-0804-14TemozolomideAmneal Pharmaceuticals, LLC14 × 1392
65162-0804-51TemozolomideAmneal Pharmaceuticals, LLC5 × 1140
65162-0805-14TemozolomideAmneal Pharmaceuticals, LLC14 × 1504
65162-0805-51TemozolomideAmneal Pharmaceuticals, LLC5 × 1180
65162-0806-51TemozolomideAmneal Pharmaceuticals, LLC5 × 1250

Medically Unlikely Edits (MUE)

CMS publishes 2 MUE values for J8700. 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 J8700 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services03 Date of Service Edit: ClinicalOral Medication; Not Payable
Facility outpatient hospital1203 Date of Service Edit: ClinicalPrescribing Information

NCCI edits and add-on relationships

No active practitioner PTP pair lists J8700 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.

J8700 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 J8700 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, J8700 carries status indicator N. Status N means payment is packaged into the associated procedure and no separate OPPS payment is made.

Common denials for J8700 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 J8700 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.

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Frequently asked questions — HCPCS J8700

What does HCPCS code J8700 describe?

J8700 is defined by CMS as "Temozolomide, 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 J8700 in October 2026?

The ASP-based payment limit is $0.208 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 $0.425.

How many units of J8700 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 J8700?

The October 2026 ASP crosswalk lists 35 NDCs from 4 labelers: Temozolomide (Accord Healthcare Inc); Temozolomide (Sun Pharmaceutical Global FZE.); Temozolomide (AvPAK); Temozolomide (Amneal Pharmaceuticals, LLC). For example NDC 16729-0048-53 is a 5 package equal to 5 billing units. The crosswalk's billing-units-per-package figure converts each package into J8700 units.

Does J8700 have NCCI bundling edits?

No active practitioner PTP pairs list J8700 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.