No. J9294 is a HCPCS Level II code, maintained by CMS, that identifies the drug supplied. CPT codes are five-digit numbers from the AMA that describe services. Giving the drug, for example an injection or infusion, is usually reported with a separate CPT administration code.

What NDCs are billed under J9294?

CMS's ASP crosswalk for October 1, 2026 through December 31, 2026 lists 6 NDCs under J9294, for Pemetrexed. The table on this page shows each one with its billing units per package.

What is the Medicare payment limit for J9294?

$3.678 per 10 mg, effective October 1, 2026 through December 31, 2026, from CMS's Part B drug payment limit file. Multiply by the units billed for the allowed amount before deductible and coinsurance. It is not a coverage decision.

What is one billing unit of J9294?

One unit of J9294 is 10 mg, as stated in the code's descriptor. Units to report = dose given ÷ 10 mg.

J9294 J-Code: Pemetrexed — Billing Units & NDCs

In short

J9294 is the HCPCS Level II code for injection, pemetrexed (hospira), not therapeutically equivalent to j9305, 10 mg. CMS assigns NDCs for Pemetrexed to it. One billing unit is 10 mg. The Medicare Part B payment limit is $3.678 per unit (October 1, 2026 through December 31, 2026).

Code

CMS HCPCS file

HCPCS codeJ9294

Billing unit10 mg

Descriptor: Injection, pemetrexed (hospira), not therapeutically equivalent to j9305, 10 mg
Short descriptor: Inj pemetrexed, hospira 10mg
Code set: HCPCS Level II, maintained by CMS
Effective: Jul 1, 2024

The billing unit is read from the descriptor. Confirm it against the CMS file before billing.

Medicare Part B payment limit

CMS ASP file

Payment limit per unit$3.678

Per10 mg

Coinsurance20%

Effective October 1, 2026 through December 31, 2026. Payment allowance limits subject to the ASP methodology are based on 2Q26 ASP data. A payment limit is not a coverage decision; the Medicare contractor decides coverage. CMS ASP pricing files

Units and claim line

Units = dose given ÷ 10 mg. For example, 1000 mg is 100 units. Enter the dose to get the units and the NDC line for the CMS-1500 and the 837P.

Dose given (mg)

HCPCS units (1 unit = 10 mg)

Modifier

NDC (11-digit)

NDC unit qualifier

NDC quantity

Enter the dose given to build the claim line.

NDCs billed under J9294

CMS’s ASP NDC–HCPCS crosswalk (effective October 1, 2026 through December 31, 2026) assigns 6 NDCs to J9294 for Pemetrexed. Billing units per package are CMS’s figures for this code’s unit.

NDCs assigned to J9294 in the CMS ASP crosswalk
Drug	NDC (11-digit)	Labeler	Package	Billing units per package
Pemetrexed	00409-0004-04	Pfizer Inc	40	100
Pemetrexed	00409-0020-02	Pfizer Inc	4	10
Pemetrexed	00409-0021-03	Pfizer Inc	20	50
Pemetrexed	00409-1045-01	Pfizer Inc	4	10
Pemetrexed	00409-2188-01	Pfizer Inc	20	50
Pemetrexed	00409-3532-01	Pfizer Inc	40	100

J9294: common questions

Is J9294 a CPT code?: No. J9294 is a HCPCS Level II code, maintained by CMS, that identifies the drug supplied. CPT codes are five-digit numbers from the AMA that describe services. Giving the drug, for example an injection or infusion, is usually reported with a separate CPT administration code. CPT codes for drug administration.
What NDCs are billed under J9294?: CMS's ASP crosswalk for October 1, 2026 through December 31, 2026 lists 6 NDCs under J9294, for Pemetrexed. The table on this page shows each one with its billing units per package.
What is the Medicare payment limit for J9294?: $3.678 per 10 mg, effective October 1, 2026 through December 31, 2026, from CMS's Part B drug payment limit file. Multiply by the units billed for the allowed amount before deductible and coinsurance. It is not a coverage decision.
What is one billing unit of J9294?: One unit of J9294 is 10 mg, as stated in the code's descriptor. Units to report = dose given ÷ 10 mg. J-code billing units.

J9294 — Injection, pemetrexed (hospira), not therapeutically equivalent to j9305, 10 mg