Reimbursement Newsletter

RJ Health provides insight into new drugs and devices, code price updates and more as it applies to medically covered drugs.

Specialty Drug Reimbursement Newsletter | August 2025

August

11

2025

RJ Health, an MMIT company, delivers industry standard specialty drug pricing, coding and reimbursement solutions to support payer and provider alignment.

Every month, our team evaluates a variety of pricing and coding updates. In the July edition of the Specialty Drug Reimbursement Newsletter, we identified 161 drug code price changes this month, with 27 of them being price decreases. We have also identified drugs to be added or updated within our database. Preview some of these insights below:

This month, during our review of the 4306 Reimbursement HCPCS/CPT® Codes in our system, we identified 161 Drug Codes that required a recalculation of their AWP Code Price. Clients can log in to www.ReimbursementCodes.com to view the pricing updates for these codes.

86580 J0185 J1575 J2327 J7527 J9298
90653 J0202 J1627 J2357 J7626 J9299
90656 J0223 J1640 J2358 J9021 J9301
90657 J0248 J1643 J2425 J9022 J9307
90658 J0257 J1644 J2468 J9023 J9308
90660 J0330 J1741 J2469 J9024 J9317
90661 J0349 J1939 J2502 J9029 J9321
90662 J0360 J1941 J2507 J9032 J9329
90673 J0456 J2060 J2781 J9041 J9331
A4230 J0480 J2182 J2783 J9042 J9333
A4259 J0490 J2260 J2820 J9043 J9347
A4614 J0491 J2270 J3032 J9055 J9358
A4627 J0584 J2277 J3055 J9063 J9359
A9154 J0585 J2312 J3230 J9153 J9380
A9526 J0592 J2323 J3241 J9173 J9381
A9543 J0603 J2327 J3247 J9176 Q0144
A9611 J0638 J2357 J3263 J9203 Q2009
B4187 J0739 J2358 J3304 J9204 Q4160
C9145 J0741 J2425 J3385 J9206 Q4263
C9293 J0870 J2468 J3411 J9223 Q4269
C9462 J0896 J2469 J3420 J9227 Q4319
E2100 J1230 J2502 J3424 J9228 Q4320
J0121 J1305 J2507 J3475 J9229 Q4321
J0129 J1306 J2781 J7295 J9263 Q5098
J0133 J1323 J2783 J7313 J9272 Q5147
J0174 J1440 J2820 J7314 J9273 S0078
J0175 J1453 J3032 J7322 J9274
J0177 J1459 J3055 J7332 J9280
J0178 J1555 J3230 J7503 J9286
J0179 J1559 J3241 J7516 J9289

ReimbursementCodes was designed for organizations like yours to manage pricing, coding and clinical challenges related to specialty drugs. To gain access to this tool and view the rest of the insights we captured this month, visit our site or contact marketing@mmitnetwork.com.

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