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US · guidance

CMS Pub. 100-04, ch. 17, § 80.1.1

HCPCS Service Coding for Oral Cancer Drugs

activein force · 2026-08-25 – presentas-observed

The following codes may be used for drugs other than Prodrugs, when covered:

Generic/Chemical Name How Supplied HCPCS

Busulfan 2 mg/ORAL J8510

Capecitabine 150mg/ORAL J8520

Capecitabine 500mg/ORAL J8521

Methotrexate 2.5 mg/ORAL J8610

Cyclophosphamide * 25 mg/ORAL J8530

Cyclophosphamide *

(Treat 50 mg. as 2 units

50 mg/ORAL J8530

Generic/Chemical Name How Supplied HCPCS

Etoposide 50 mg/ORAL J8560

Melphalan 2 mg/ORAL J8600

Prescription Drug chemotherapeutic

NOC

ORAL J8999

Each tablet or capsule is equal to one unit, except for 50 mg/ORAL of cyclophosphamide (J8530),

which is shown as 2 units. The 25mg and 50 mg share the same code.

NOTE: HIPAA requires that drug claims submitted to DME MACs be identified by NDC.

History

(Rev. 1, 10-01-03)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
a8001ac89c84530d4312e91ad045c0356cd44f6fd2fefe24a36ebd6207153ee2
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