HCPCS code J7512: Prednisone, per 1 mg2026 Medicare rate & RVUs in Massachusetts
Report immediate- or delayed-release oral prednisone by milligram when the drug is furnished for a Medicare-covered service.
CMS doesn’t publish an office rate for J7512 in Massachusetts.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What J7512 covers
Prednisone is an oral corticosteroid used to reduce inflammation and suppress immune activity. It is prescribed for inflammatory, allergic, and autoimmune conditions and may be included in immunosuppressive therapy after organ transplantation. J7512 identifies both immediate- and delayed-release oral prednisone, rather than an injectable formulation. The code represents the drug, not a service for prescribing or administering it.
CMS assigns J7512 status E, excluding it from the physician fee schedule. When Medicare covers the drug, payment is under another method; HCPCS classifies it as a Part B drug, generally priced using CMS quarterly ASP drug pricing files. Special Medicare coverage instructions apply. Each unit represents 1 mg of prednisone, so report units based on the total milligrams furnished; 10 mg equals 10 units.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where J7512 pays more and less in Massachusetts
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Boston, MA | Unavailable | Unavailable |
| Rest of Massachusetts | Unavailable | Unavailable |
How the J7512 rate is calculated
Each of J7512’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · J7512
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense0.00
0.00 RVUs× 1.000 GPCI
Malpractice0.00
0.00 RVUs× 1.000 GPCI
Adjusted RVUs
0.0000
Conversion factor
$33.4009
Medicare rate
$0.00
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for J7512
J7512 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.
Place of service · J7512
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
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J7512 isn’t priced in this setting.
J7512 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- J7510PrednisolonePer 5 mg
- J7510 is for oral prednisolone and counts each 5 mg; J7512 is for oral prednisone and counts each 1 mg.
- J7509Oral methylprednisolonePer 4 mg
- J7509 identifies oral methylprednisolone. Choose J7512 for oral prednisone, not a different corticosteroid.
- J7507Oral tacrolimusImmediate release, per 1 mg
- J7507 identifies immediate-release oral tacrolimus, not prednisone; the codes represent different drugs even though both use a 1 mg unit.
J7512 billing questions
How many units should be reported?
Report one unit for each 1 mg of prednisone furnished. For example, 10 mg corresponds to 10 units.
How does J7512 differ from J7510?
J7512 identifies oral prednisone, counted per 1 mg. J7510 identifies oral prednisolone and uses a 5 mg unit.
Is J7512 the code for injectable prednisone?
No. J7512 identifies oral prednisone, not an injectable formulation.
Does Medicare pay J7512 under the physician fee schedule?
No. CMS assigns status E, excluding it from the physician fee schedule. When covered, it is paid under another method; HCPCS classifies it as a Part B drug generally priced using quarterly ASP files, with special coverage instructions.
What documentation supports the reported units?
The record should support the oral prednisone furnished and its milligram quantity so the units can be calculated at 1 unit per mg.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
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