Product attributes as listed by the labeler in the FDA NDC Directory.
Also searchable as: Acetaminophen
Drug codes appear here only when a CMS NDC–HCPCS crosswalk lists at least one of this drug’s NDC packages. CodeRx never assigns a code from the name or ingredient.
Injection, acetaminophen, not otherwise specified,10 mg
Derived: 10 of 28 NDC package(s) for this drug appear in the CMS NDC–HCPCS crosswalk for J0131. CMS quarters Q1 2023 – Q4 2026
J-codes are permanent national codes for drugs and biologicals — most often clinician-administered (buy-and-bill) products paid under Medicare Part B — plus certain immunosuppressive, inhalation (via DME), and oral anticancer/antiemetic drugs. Units are reported in multiples of the dosage in the code descriptor.
Package NDCs from the FDA directory, normalized to the 11-digit 5-4-2 format used on claims.
| 11-digit NDC | FDA NDC | Package description | Strength · form | Labeler | HCPCS · units / NDC | Status |
|---|---|---|---|---|---|---|
| 00143-9386-10 | 0143-9386-10 | 10 BAG in 1 CARTON (0143-9386-10) / 100 mL in 1 BAG (0143-9386-01) | 1000 mg/100mLInjection | Hikma Pharmaceuticals USA Inc. | J0137 · 1,000 units |
One HCPCS billing unit of J0131
10 MG
Medicare payment limit per unit (Q4 2026): $0.044
One HCPCS billing unit of J0134
10 MG
Medicare payment limit per unit (Q4 2026): $0.051
One HCPCS billing unit of J0136
Medicare Part B payment limits for the codes above, then how the home infusion per diem S-codes are paid. Commercial payer rates, AWP, and WAC are not included.
| Quarter | Effective | Payment limit | Per (billing unit) | Coinsurance | Change | CMS notes |
|---|---|---|---|---|---|---|
| Q4 2026 | Oct 1, 2026 – Dec 31, 2026 | $0.044 | 10 MG | 20% | −12.0% |
Medicare coverage is set nationally (NCDs) and by each Medicare Administrative Contractor (LCDs and Billing & Coding articles). These links open the official documents.
Which Medicare benefit pays for this drug?
ICD-10-CM codes that Medicare contractors' Billing and Coding articles list as supporting medical necessity for this drug's HCPCS codes — covered diagnoses, not how often each is used. Washington (Noridian JF) articles come first; other contractors' articles are linked below.
No current Medicare Billing and Coding article lists J0131, J0134, J0136, J0137.
Quarterly changes to the HCPCS codes linked to this drug.
| Quarterly file | Change | CMS action code | Details |
|---|---|---|---|
| Q1 2023 | In earliest ingested file | C — Long description changed | Added date Jan 1, 2012 |
| Quarterly file | Change | CMS action code | Details |
|---|
Disclaimer. This application provides informational coding and reimbursement reference data. It does not constitute legal, clinical, coding, or billing advice. Codes, payment amounts, payer rules, and coverage policies can change. Verify all information with current CMS publications, the applicable payer, and your organization’s compliance policies before submitting a claim. CodeRx is not affiliated with or endorsed by CMS, FDA, Medicare, or any payer.
Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg
Derived: 1 of 28 NDC package(s) for this drug appear in the CMS NDC–HCPCS crosswalk for J0134. CMS quarters Q1 2023 – Q4 2026
J-codes are permanent national codes for drugs and biologicals — most often clinician-administered (buy-and-bill) products paid under Medicare Part B — plus certain immunosuppressive, inhalation (via DME), and oral anticancer/antiemetic drugs. Units are reported in multiples of the dosage in the code descriptor.
Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg
Derived: 5 of 28 NDC package(s) for this drug appear in the CMS NDC–HCPCS crosswalk for J0136. CMS quarters Q1 2023 – Q4 2026
J-codes are permanent national codes for drugs and biologicals — most often clinician-administered (buy-and-bill) products paid under Medicare Part B — plus certain immunosuppressive, inhalation (via DME), and oral anticancer/antiemetic drugs. Units are reported in multiples of the dosage in the code descriptor.
Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg
Derived: 1 of 28 NDC package(s) for this drug appear in the CMS NDC–HCPCS crosswalk for J0137. CMS quarters Q3 2023 – Q4 2026
J-codes are permanent national codes for drugs and biologicals — most often clinician-administered (buy-and-bill) products paid under Medicare Part B — plus certain immunosuppressive, inhalation (via DME), and oral anticancer/antiemetic drugs. Units are reported in multiples of the dosage in the code descriptor.
When a home infusion pharmacy dispenses this drug, the drug is billed with the code above and each day of pharmacy services, supplies, and equipment with a per diem S-code. CMS publishes no drug-to-per-diem crosswalk, so CodeRx picks the therapy category from the FDA pharmacologic class and route. S-codes are not payable by Medicare; confirm the code against the payer contract.
No category matched · FDA class: No FDA pharmacologic class (EPC) listed
No specific category was found in this drug’s FDA pharmacologic class. Use a specific code instead when the therapy is one CodeRx cannot detect: hydration (S9373–S9377), tocolytic (S9349), anti-spasmodic (S9363), blood products (S9538), or irrigation (S9590).
| 00264-4050-80 | 0264-4050-80 | 24 CONTAINER in 1 CASE (0264-4050-80) / 50 mL in 1 CONTAINER | 10 mg/mLInjection | B. Braun Medical Inc. | J0136 · 1,200 units | Listed |
|---|
| 00264-4050-90 | 0264-4050-90 | 24 CONTAINER in 1 CASE (0264-4050-90) / 50 mL in 1 CONTAINER | 10 mg/mLInjection | B. Braun Medical Inc. | J0136 · 1,200 units (Q3 2026) | Listed |
|---|
| 00264-4100-90 | 0264-4100-90 | 24 CONTAINER in 1 CASE (0264-4100-90) / 100 mL in 1 CONTAINER | 10 mg/mLInjection | B. Braun Medical Inc. | J0136 · 2,400 units | Listed |
|---|
| 00781-3156-95 | 0781-3156-95 | 10 VIAL, GLASS in 1 CARTON (0781-3156-95) / 100 mL in 1 VIAL, GLASS (0781-3156-06) | 10 mg/mLInjection, Solution | Sandoz Inc | J0131 · 1,000 units | Listed |
|---|
| 00781-9274-95 | 0781-9274-95 | 10 VIAL, GLASS in 1 CARTON (0781-9274-95) / 100 mL in 1 VIAL, GLASS (0781-9274-06) | 10 mg/mLInjection, Solution | Sandoz Inc | J0131 · 1,000 units | Listed |
|---|
| 24201-0100-24 | 24201-100-24 | 24 VIAL, GLASS in 1 CARTON (24201-100-24) / 100 mL in 1 VIAL, GLASS | 10 mg/mLInjection, Solution | Hikma Pharmaceuticals USA Inc. | J0131 · 2,400 units | Listed |
|---|
| 24201-0110-24 | 24201-110-24 | 24 VIAL, GLASS in 1 CARTON (24201-110-24) / 100 mL in 1 VIAL, GLASS | 10 mg/mLInjection, Solution | Hikma Pharmaceuticals USA Inc. | J0131 · 2,400 units | Listed |
|---|
| 25021-0705-82 | 25021-705-82 | 10 BAG in 1 CARTON (25021-705-82) / 50 mL in 1 BAG | 10 mg/mLInjection, Solution | Sagent Pharmaceuticals | J0136 · 500 units | Listed |
|---|
| 25021-0705-87 | 25021-705-87 | 20 BAG in 1 CARTON (25021-705-87) / 100 mL in 1 BAG | 10 mg/mLInjection, Solution | Sagent Pharmaceuticals | J0136 · 2,000 units | Listed |
|---|
| 31722-0205-10 | 31722-205-10 | 10 VIAL, SINGLE-DOSE in 1 CARTON (31722-205-10) / 100 mL in 1 VIAL, SINGLE-DOSE (31722-205-31) | 10 mg/mLInjection, Solution | Camber Pharmaceuticals, Inc. | Not in CMS crosswalk | Listed |
|---|
| 31722-0205-24 | 31722-205-24 | 24 VIAL, SINGLE-DOSE in 1 CARTON (31722-205-24) / 100 mL in 1 VIAL, SINGLE-DOSE (31722-205-31) | 10 mg/mLInjection, Solution | Camber Pharmaceuticals, Inc. | Not in CMS crosswalk | Listed |
|---|
| 36000-0306-60 | 36000-306-60 | 40 BAG in 1 CARTON (36000-306-60) / 100 mL in 1 BAG | 10 mg/mLInjection, Solution | Baxter Healthcare Corporation | J0131 · 4,000 units | Listed |
|---|
| 36000-0372-40 | 36000-372-40 | 40 BAG in 1 CARTON (36000-372-40) / 65 mL in 1 BAG | 10 mg/mLInjection, Solution | Baxter Healthcare Corporation | J0131 · 2,600 units | Listed |
|---|
| 44567-0340-10 | 44567-340-10 | 10 BAG in 1 CARTON (44567-340-10) / 100 mL in 1 BAG (44567-340-01) | 10 mg/mLInjection, Solution | WG Critical Care, LLC | Not in CMS crosswalk | Listed |
|---|
| 51662-1540-03 | 51662-1540-3 | 24 POUCH in 1 CASE (51662-1540-3) / 1 VIAL, SINGLE-DOSE in 1 POUCH (51662-1540-2) / 100 mL in 1 VIAL, SINGLE-DOSE (51662-1540-1) | 10 mg/mLInjection, Solution | HF Acquisition Co LLC, DBA HealthFirst | J0131 · 2,400 units | Listed |
|---|
| 55150-0307-24 | 55150-307-24 | 24 VIAL, SINGLE-DOSE in 1 CARTON (55150-307-24) / 100 mL in 1 VIAL, SINGLE-DOSE (55150-307-01) | 10 mg/mLInjection, Solution | Eugia US LLC | J0131 · 2,400 units | Listed |
|---|
| 55579-0110-01 | 55579-110-01 | 24 BOTTLE in 1 BOTTLE (55579-110-01) / 100 mL in 1 BOTTLE | 1000 mg/100mLInjection | Solupharm Pharmazeutische Erzeugnisse GmbH | Not in CMS crosswalk | Listed |
|---|
| 55579-0405-24 | 55579-405-24 | 24 VIAL, GLASS in 1 CARTON (55579-405-24) / 100 mL in 1 VIAL, GLASS | 10 mg/mLInjection, Solution | Solupharm Pharmazeutische Erzeugnisse GmbH | Not in CMS crosswalk | Listed |
|---|
| 63323-0434-00 | 63323-434-00 | 20 BAG in 1 CASE (63323-434-00) / 100 mL in 1 BAG (63323-434-41) | 10 mg/mLInjection | Fresenius Kabi USA, LLC | J0134 · 2,000 units | Listed |
|---|
| 65145-0157-10 | 65145-157-10 | 10 POUCH in 1 CASE (65145-157-10) / 1 BAG in 1 POUCH (65145-157-01) / 100 mL in 1 BAG | 10 mg/mLInjection, Solution | Caplin Steriles Limited | Not in CMS crosswalk | Listed |
|---|
| 67457-0940-10 | 67457-940-10 | 24 BAG in 1 CARTON (67457-940-10) / 100 mL in 1 BAG | 1000 mg/100mLInjection, Solution | Mylan Institutional LLC | J0131 · 2,400 units | Listed |
|---|
| 68083-0647-01 | 68083-647-01 | 24 BAG in 1 CARTON (68083-647-01) / 50 mL in 1 BAG | 10 mg/mLInjection, Solution | Gland Pharma Limited | Not in CMS crosswalk | Listed |
|---|
| 68083-0648-01 | 68083-648-01 | 24 BAG in 1 CARTON (68083-648-01) / 100 mL in 1 BAG | 10 mg/mLInjection, Solution | Gland Pharma Limited | Not in CMS crosswalk | Listed |
|---|
| 70069-0871-10 | 70069-871-10 | 10 POUCH in 1 CASE (70069-871-10) / 1 BAG in 1 POUCH (70069-871-01) / 100 mL in 1 BAG | 10 mg/mLInjection, Solution | Somerset Therapeutics, LLC | Not in CMS crosswalk | Listed |
|---|
| 70518-4184-02 | 70518-4184-2 | 25 VIAL, SINGLE-DOSE in 1 CARTON (70518-4184-2) / 100 mL in 1 VIAL, SINGLE-DOSE (70518-4184-3) | 10 mg/mLInjection, Solution | REMEDYREPACK INC. | Not in CMS crosswalk | Listed |
|---|
| 72572-0050-10 | 72572-050-10 | 10 VIAL, GLASS in 1 CARTON (72572-050-10) / 100 mL in 1 VIAL, GLASS (72572-050-01) | 10 mg/mLInjection, Solution | Civica, Inc. | J0131 · 1,000 units | Listed |
|---|
| 84549-0100-90 | 84549-100-90 | 100 mL in 1 CONTAINER (84549-100-90) | 10 mg/mLInjection | ProPharma Distribution | Not in CMS crosswalk | Listed |
|---|
10 MG
Medicare payment limit per unit (Q4 2026): $0.046
One HCPCS billing unit of J0137
10 MG
Medicare payment limit per unit (Q4 2026): $0.048
Billable units per package for each NDC are listed in the NDC packages table above (CMS “BILLUNITSPKG”).
| — |
| Q3 2026 | Jul 1, 2026 – Sep 30, 2026 | $0.050 | 10 MG | 20% | −2.0% | — |
|---|
| Q2 2026 | Apr 1, 2026 – Jun 30, 2026 | $0.051 | 10 MG | 20% | −8.9% | — |
|---|
| Q1 2026 | Jan 1, 2026 – Mar 31, 2026 | $0.056 | 10 MG | 20% | −1.8% | — |
|---|
| Q4 2025 | Oct 1, 2025 – Dec 31, 2025 | $0.057 | 10 MG | 20% | +5.6% | — |
|---|
| Q3 2025 | Jul 1, 2025 – Sep 30, 2025 | $0.054 | 10 MG | 20% | +3.8% | — |
|---|
| Q2 2025 | Apr 1, 2025 – Jun 30, 2025 | $0.052 | 10 MG | 20% | +8.3% | — |
|---|
| Q1 2025 | Jan 1, 2025 – Mar 31, 2025 | $0.048 | 10 MG | 20% | +17.1% | — |
|---|
| Q4 2024 | Oct 1, 2024 – Dec 31, 2024 | $0.041 | 10 MG | 20% | −24.1% | — |
|---|
| Q3 2024 | Jul 1, 2024 – Sep 30, 2024 | $0.054 | 10 MG | 20% | +8.0% | — |
|---|
| Q2 2024 | Apr 1, 2024 – Jun 30, 2024 | $0.050 | 10 MG | 20% | +8.7% | — |
|---|
| Q1 2024 | Jan 1, 2024 – Mar 31, 2024 | $0.046 | 10 MG | 20% | −36.1% | — |
|---|
| Q4 2023 | Oct 1, 2023 – Dec 31, 2023 | $0.072 | 10 MG | 20% | −16.3% | — |
|---|
| Q3 2023 | Jul 1, 2023 – Sep 30, 2023 | $0.086 | 10 MG | 20% | −13.1% | — |
|---|
| Q2 2023 | Apr 1, 2023 – Jun 30, 2023 | $0.099 | 10 MG | 20% | −2.0% | — |
|---|
| Q1 2023 | Jan 1, 2023 – Mar 31, 2023 | $0.101 | 10 MG | — | — | Added January 2023 |
|---|
| Quarter | Effective | Payment limit | Per (billing unit) | Coinsurance | Change | CMS notes |
|---|---|---|---|---|---|---|
| Q4 2026 | Oct 1, 2026 – Dec 31, 2026 | $0.051 | 10 MG | 20% | +2.0% | — |
| Q3 2026 | Jul 1, 2026 – Sep 30, 2026 | $0.050 | 10 MG | 20% | −5.7% | — |
| Q2 2026 | Apr 1, 2026 – Jun 30, 2026 | $0.053 | 10 MG | 20% | −5.4% | — |
| Q1 2026 | Jan 1, 2026 – Mar 31, 2026 | $0.056 | 10 MG | 20% | +1.8% | — |
| Q4 2025 | Oct 1, 2025 – Dec 31, 2025 | $0.055 | 10 MG | 20% | −1.8% | — |
| Q3 2025 | Jul 1, 2025 – Sep 30, 2025 | $0.056 | 10 MG | 20% | +7.7% | — |
| Q2 2025 | Apr 1, 2025 – Jun 30, 2025 | $0.052 | 10 MG | 20% | +23.8% | — |
| Q1 2025 | Jan 1, 2025 – Mar 31, 2025 | $0.042 | 10 MG | 20% | +2.4% | — |
| Q4 2024 | Oct 1, 2024 – Dec 31, 2024 | $0.041 | 10 MG | 20% | −14.6% | — |
| Q3 2024 | Jul 1, 2024 – Sep 30, 2024 | $0.048 | 10 MG | 20% | −4.0% | — |
| Q2 2024 | Apr 1, 2024 – Jun 30, 2024 | $0.050 | 10 MG | 20% | +6.4% | AMP-based payment limit |
| Q1 2024 | Jan 1, 2024 – Mar 31, 2024 | $0.047 | 10 MG | 20% | −7.8% | AMP-based payment limit |
| Q4 2023 | Oct 1, 2023 – Dec 31, 2023 | $0.051 | 10 MG | 20% | −26.1% | AMP-based payment limit |
| Q3 2023 | Jul 1, 2023 – Sep 30, 2023 | $0.069 | 10 MG | 20% | −36.7% | — |
| Q2 2023 | Apr 1, 2023 – Jun 30, 2023 | $0.109 | 10 MG | 20% | −21.6% | — |
| Q1 2023 | Jan 1, 2023 – Mar 31, 2023 | $0.139 | 10 MG | — | — | Added January 2023 |
| Quarter | Effective | Payment limit | Per (billing unit) | Coinsurance | Change | CMS notes |
|---|---|---|---|---|---|---|
| Q4 2026 | Oct 1, 2026 – Dec 31, 2026 | $0.046 | 10 MG | 20% | −2.1% | — |
| Q3 2026 | Jul 1, 2026 – Sep 30, 2026 | $0.047 | 10 MG | 20% | −6.0% | — |
| Q2 2026 | Apr 1, 2026 – Jun 30, 2026 | $0.050 | 10 MG | 20% | −2.0% | — |
| Q1 2026 | Jan 1, 2026 – Mar 31, 2026 | $0.051 | 10 MG | 20% | +6.2% | — |
| Q4 2025 | Oct 1, 2025 – Dec 31, 2025 | $0.048 | 10 MG | 20% | −2.0% | — |
| Q3 2025 | Jul 1, 2025 – Sep 30, 2025 | $0.049 | 10 MG | 20% | +0.0% | — |
| Q2 2025 | Apr 1, 2025 – Jun 30, 2025 | $0.049 | 10 MG | 20% | +0.0% | — |
| Q1 2025 | Jan 1, 2025 – Mar 31, 2025 | $0.049 | 10 MG | 20% | +2.1% | — |
| Q4 2024 | Oct 1, 2024 – Dec 31, 2024 | $0.048 | 10 MG | 20% | −4.0% | — |
| Q3 2024 | Jul 1, 2024 – Sep 30, 2024 | $0.050 | 10 MG | 20% | −3.8% | — |
| Q2 2024 | Apr 1, 2024 – Jun 30, 2024 | $0.052 | 10 MG | 20% | −7.1% | — |
| Q1 2024 | Jan 1, 2024 – Mar 31, 2024 | $0.056 | 10 MG | 20% | +3.7% | — |
| Q4 2023 | Oct 1, 2023 – Dec 31, 2023 | $0.054 | 10 MG | 20% | +0.0% | — |
| Q3 2023 | Jul 1, 2023 – Sep 30, 2023 | $0.054 | 10 MG | 20% | +3.8% | — |
| Q2 2023 | Apr 1, 2023 – Jun 30, 2023 | $0.052 | 10 MG | 20% | +6.1% | — |
| Q1 2023 | Jan 1, 2023 – Mar 31, 2023 | $0.049 | 10 MG | — | — | Added January 2023 |
| Quarter | Effective | Payment limit | Per (billing unit) | Coinsurance | Change | CMS notes |
|---|---|---|---|---|---|---|
| Q4 2026 | Oct 1, 2026 – Dec 31, 2026 | $0.048 | 10 MG | 20% | +0.0% | — |
| Q3 2026 | Jul 1, 2026 – Sep 30, 2026 | $0.048 | 10 MG | 20% | −15.8% | — |
| Q2 2026 | Apr 1, 2026 – Jun 30, 2026 | $0.057 | 10 MG | 20% | +7.5% | — |
| Q1 2026 | Jan 1, 2026 – Mar 31, 2026 | $0.053 | 10 MG | 20% | +8.2% | — |
| Q4 2025 | Oct 1, 2025 – Dec 31, 2025 | $0.049 | 10 MG | 20% | −2.0% | — |
| Q3 2025 | Jul 1, 2025 – Sep 30, 2025 | $0.050 | 10 MG | 20% | +100.0% | — |
| Q2 2025 | Apr 1, 2025 – Jun 30, 2025 | $0.025 | 10 MG | 20% | −47.9% | — |
| Q1 2025 | Jan 1, 2025 – Mar 31, 2025 | $0.048 | 10 MG | 20% | −9.4% | — |
| Q4 2024 | Oct 1, 2024 – Dec 31, 2024 | $0.053 | 10 MG | 20% | +0.0% | — |
| Q3 2024 | Jul 1, 2024 – Sep 30, 2024 | $0.053 | 10 MG | 20% | −19.7% | — |
| Q2 2024 | Apr 1, 2024 – Jun 30, 2024 | $0.066 | 10 MG | 20% | +29.4% | — |
| Q1 2024 | Jan 1, 2024 – Mar 31, 2024 | $0.051 | 10 MG | 20% | −23.9% | — |
| Q4 2023 | Oct 1, 2023 – Dec 31, 2023 | $0.067 | 10 MG | 20% | −10.7% | — |
| Q3 2023 | Jul 1, 2023 – Sep 30, 2023 | $0.075 | 10 MG | 20% | — | Added July 2023 |
| Code | Description (CMS) | Max fee · Non-rural | Max fee · Rural | PA / EPA | HCA comments |
|---|---|---|---|---|---|
| A4220 | Infusion pump refill kit | $24.61 | N/A | — | See Home Infusion & Parenteral Nutrition Billing Guide for Details |
| A4221 | Supp non-insulin inf cath/wk | $24.96 | N/A | — | — |
| A4222 | Infusion supplies with pump | $47.35 | N/A | — | — |
| A4223 | Infusion supplies w/o pump | BR* | N/A | — | *Please see 2nd Tab for Requirements |
Maximum allowable fees as published by HCA, per billing unit of each code. BR = by report (invoice required); DP = covered under another program (see comments); N/A = no separate rate for that area. HCA pays the lesser of the provider’s usual charge and the maximum allowable fee (WAC 182-553).
How Medicare pays for home infusion instead
Medicare pays no per diem. Under its home infusion therapy services benefit, a qualified home infusion supplier is paid per infusion day, and only for drugs given through a Medicare-covered external infusion pump:
Verification neededCodeRx links to coverage documents instead of copying them: CMS distributes their code lists under AMA, ADA, and AHA license terms that limit reuse. Medicare Advantage, Medicaid, and commercial plans set their own coverage and prior-authorization rules.
| Q3 2024 | Descriptor changed | C — Long description changed | Now: Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mgBefore: Injection, acetaminophen (fresenius kabi) not therapeutically equivalent to j0131, 10 mg |
|---|---|---|---|
| Q3 2024 | Dates changed | C — Long description changed | Added Jan 1, 2023 · action effective Jul 1, 2024 · termination — |
| Q1 2024 | Dates changed | P — Payment change | Added Jan 1, 2023 · action effective Jan 1, 2024 · termination — |
| Q1 2023 | In earliest ingested file | A — Added | Added date Jan 1, 2023 |
| Quarterly file | Change | CMS action code | Details |
|---|---|---|---|
| Q3 2024 | Descriptor changed | C — Long description changed | Now: Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mgBefore: Injection, acetaminophen (b braun) not therapeutically equivalent to j0131, 10 mg |
| Q3 2024 | Dates changed | C — Long description changed | Added Jan 1, 2023 · action effective Jul 1, 2024 · termination — |
| Q1 2024 | Dates changed | P — Payment change | Added Jan 1, 2023 · action effective Jan 1, 2024 · termination — |
| Q1 2023 | In earliest ingested file | A — Added | Added date Jan 1, 2023 |
| Quarterly file | Change | CMS action code | Details |
|---|---|---|---|
| Q3 2024 | Descriptor changed | C — Long description changed | Now: Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mgBefore: Injection, acetaminophen (hikma) not therapeutically equivalent to j0131, 10 mg |
| Q3 2024 | Dates changed | C — Long description changed | Added Jul 1, 2023 · action effective Jul 1, 2024 · termination — |
| Q1 2024 | Dates changed | P — Payment change | Added Jul 1, 2023 · action effective Jan 1, 2024 · termination — |
| Q3 2023 | Added to HCPCS | A — Added | Added date Jul 1, 2023 |
Every import with its checksum is listed on the data sources page.
| A4224 | Supply insulin inf cath/wk | $24.96 | N/A | — | See Home Infusion & Parenteral Nutrition Billing Guide for Details |
|---|
| A4225 | Sup/ext insulin inf pump syr | $3.35 | N/A | — | — |
|---|
| A4230 | Infus insulin pump non needl | $201.45 | N/A | — | See Home Infusion & Parenteral Nutrition Billing Guide for Details |
|---|
| A4231 | Infusion insulin pump needle | $134.29 | N/A | — | See Home Infusion & Parenteral Nutrition Billing Guide for Details |
|---|
| A4232 | Syringe w/needle insulin 3cc | $79.14 | N/A | — | See Home Infusion & Parenteral Nutrition Billing Guide for Details |
|---|
| A4238 | Adju cgm supply allowance | $270.89 | N/A | EPA | Invoice Required/See Home Infusion & Parenteral Nutrition Billing Guide for Details |
|---|
| A4239 | Non-adju cgm supply allow | $263.72 | N/A | EPA | Limit: 1 unit/month - See Home Infusion & Parenteral Nutrition Billing Guide for Details |
|---|
| A4246 | Betadine/phisohex solution | $2.87 | N/A | — | See Home Infusion & Parenteral Nutrition Billing Guide for Details |
|---|
| A4247 | Betadine/iodine swabs/wipes | $4.55 | N/A | — | See Home Infusion & Parenteral Nutrition Billing Guide for Details |
|---|
| A4602 | Replace lithium battery 1.5v | $5.31 | N/A | — | See Home Infusion & Parenteral Nutrition Billing Guide for Details |
|---|
| A4927 | Non-sterile gloves | DP | N/A | PA - Exceptions to Max | Please see Medical Equipment Fee Schedule for rates |
|---|
| A4930 | Sterile, gloves per pair | DP | N/A | — | Please see Medical Equipment Fee Schedule for rates |
|---|
| A9276 | Disposable sensor, cgm sys | BR | N/A | PA/EPA | Invoice Required/See Home Infusion & Parenteral Nutrition Billing Guide for Details |
|---|
| A9277 | External transmitter, cgm | BR | N/A | PA/EPA | invoice required |
|---|
| A9278 | External receiver, cgm sys | BR | N/A | PA/EPA | Invoice Required/See Home Infusion & Parenteral Nutrition Billing Guide for Details |
|---|
| B4164 | Parenteral 50% dextrose solu | $18.8947 | N/A | — | — |
|---|
| B4168 | Parenteral sol amino acid 3. | $27.5508 | N/A | — | — |
|---|
| B4172 | Parenteral sol amino acid 5. | $31.74 | N/A | — | — |
|---|
| B4176 | Parenteral sol amino acid 7- | $53.3162 | N/A | — | — |
|---|
| B4178 | Parenteral sol amino acid > | $63.9988 | N/A | — | — |
|---|
| B4180 | Parenteral sol carb > 50% | $27.1261 | N/A | — | — |
|---|
| B4185 | Pn soln nos 10 grams lipids | $12.4967 | N/A | — | — |
|---|
| B4189 | Parenteral sol amino acid & | $197.7092 | N/A | — | — |
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| B4193 | Parenteral sol 52-73 gm prot | $255.4644 | N/A | — | — |
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| B4197 | Parenteral sol 74-100 gm pro | $311.0195 | N/A | — | — |
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| B4199 | Parenteral sol > 100gm prote | $355.3902 | N/A | — | — |
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| B4216 | Parenteral nutrition additiv | $8.5885 | N/A | — | — |
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| B4220 | Parenteral supply kit premix | $8.907 | N/A | — | See Home Infusion & Parenteral Nutrition Billing Guide for Details |
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| B4222 | Parenteral supply kit homemi | $10.9817 | N/A | — | See Home Infusion & Parenteral Nutrition Billing Guide for Details |
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| B4224 | Parenteral administration ki | $27.8113 | N/A | — | See Home Infusion & Parenteral Nutrition Billing Guide for Details |
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| B5000 | Parenteral sol renal-amirosy | $13.2205 | N/A | — | — |
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| B5100 | Parenteral solution hepatic | $5.1627 | N/A | — | — |
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| B9004-NU | Parenteral infus pump portab | $2,806.3937 | N/A | — | — |
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| B9004-RR | Parenteral infus pump portab | $444.257 | N/A | — | See Home Infusion & Parenteral Nutrition Billing Guide for Details |
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| B9006-NU | Parenteral infus pump statio | $2,806.3937 | N/A | — | — |
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| B9006-RR | Parenteral infus pump statio | $444.257 | N/A | — | See Home Infusion & Parenteral Nutrition Billing Guide for Details |
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| B9999 | Parenteral supp not othrws c | BR | N/A | PA | invoice required |
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| E0776-NU | Iv pole | $177.29 | N/A | — | — |
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| E0776-RR | Iv pole | $17.73 | N/A | — | See Home Infusion & Parenteral Nutrition Billing Guide for Details |
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| E0779-RR | Amb infusion pump mechanical | $23.00 | $23.00 | — | — |
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| E0780-NU | Mech amb infusion pump <8hrs | $14.26 | N/A | — | — |
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| E0781-RR | External ambulatory infus pu | $298.50 | $331.38 | — | — |
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| E0784-RR | Ext amb infusn pump insulin | $538.23 | $556.19 | PA | For Omnipod See Pharmacy Benefit/See Home Infusion & Parenteral Nutrion Billing Guide fo rDetails |
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| E0791-RR | Parenteral infusion pump sta | $354.62 | $394.73 | — | — |
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| E1399 | Durable medical equipment mi | BR | N/A | PA | Invoice Required |
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| E2102-NU | Adju cgm receiver/monitor | $226.32 | N/A | EPA | See Home Infusion & Parenteral Nutrition Billing Guide for Details |
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| E2102-RR | Adju cgm receiver/monitor | $22.63 | N/A | EPA | See Home Infusion & Parenteral Nutrition Billing Guide for Details |
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| E2102-UE | Adju cgm receiver/monitor | $169.75 | N/A | EPA | See Home Infusion & Parenteral Nutrition Billing Guide for Details |
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| E2103 | Non-adju cgm receiver/mon | $290.73 | N/A | EPA | See Home Infusion & Parenteral Nutrition Billing Guide for Details |
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| K0601 | Repl batt silver oxide 1.5 v | $1.52 | N/A | — | See Home Infusion & Parenteral Nutrition Billing Guide for Details |
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| K0602 | Repl batt silver oxide 3 v | $8.57 | N/A | — | See Home Infusion & Parenteral Nutrition Billing Guide for Details |
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| K0603 | Repl batt alkaline 1.5 v | $0.77 | N/A | — | See Home Infusion & Parenteral Nutrition Billing Guide for Details |
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| K0604 | Repl batt lithium 3.6 v | $8.26 | N/A | — | — |
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| K0605 | Repl batt lithium 4.5 v | $19.73 | N/A | — | — |
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| K0739 | Repair/svc dme non-oxygen eq | $30.90 | N/A | PA | — |
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