Product attributes as listed by the labeler in the FDA NDC Directory.
FDA pharmacologic class: Carbapenems [CS]; Penem Antibacterial [EPC]
Also searchable as: Meropenem · meropenem anhydrous
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, meropenem (wg critical care), not therapeutically equivalent to j2185, 100 mg
Derived: 2 of 62 NDC package(s) for this drug appear in the CMS NDC–HCPCS crosswalk for J2183. CMS quarters Q3 2024 – 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 |
|---|---|---|---|---|---|---|
| 00143-9430-10 | 0143-9430-10 | 10 VIAL in 1 CARTON (0143-9430-10) / 20 mL in 1 VIAL (0143-9430-01) | 500 mg/20mLInjection | Hikma Pharmaceuticals USA Inc. | J2185 · 50 units |
One HCPCS billing unit of J2183
100 MG
Medicare payment limit per unit (Q4 2026): $1.339
One HCPCS billing unit of J2185
100 MG
Medicare payment limit per unit (Q4 2026): $0.358
Billable units per package for each NDC are listed in the NDC packages table above (CMS “BILLUNITSPKG”).
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 | $1.339 | 100 MG | 20% | −4.9% |
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 J2183, J2185.
Quarterly changes to the HCPCS codes linked to this drug.
| Quarterly file | Change | CMS action code | Details |
|---|---|---|---|
| Q2 2025 | Dates changed | N — No maintenance | Added Jul 1, 2024 · action effective Jan 1, 2025 · termination — |
| Q3 2024 | Added to HCPCS | A — Added | Added date Jul 1, 2024 |
| Quarterly file |
|---|
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, meropenem, 100 mg
Derived: 40 of 62 NDC package(s) for this drug appear in the CMS NDC–HCPCS crosswalk for J2185. CMS quarters Q1 2021 – 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.
Matched on: Penem Antibacterial
Pick the code that matches the prescribed dosing interval.
| 00143-9431-10 | 0143-9431-10 | 10 VIAL in 1 CARTON (0143-9431-10) / 30 mL in 1 VIAL (0143-9431-01) | 1 g/30mLInjection | Hikma Pharmaceuticals USA Inc. | J2185 · 100 units | Listed |
|---|
| 00143-9485-10 | 0143-9485-10 | 10 VIAL in 1 CARTON (0143-9485-10) / 10 mL in 1 VIAL (0143-9485-01) | 500 mg/10mLInjection, Powder, For Solution | Hikma Pharmaceuticals USA Inc. | Not in CMS crosswalk | Listed |
|---|
| 00143-9486-10 | 0143-9486-10 | 10 VIAL in 1 CARTON (0143-9486-10) / 20 mL in 1 VIAL (0143-9486-01) | 1 g/20mLInjection, Powder, For Solution | Hikma Pharmaceuticals USA Inc. | Not in CMS crosswalk | Listed |
|---|
| 00409-0222-10 | 0409-0222-10 | 10 VIAL in 1 CARTON (0409-0222-10) / 10 mL in 1 VIAL (0409-0222-01) | 500 mg/10mLInjection, Powder, For Solution | Hospira, Inc. | J2185 · 50 units | Listed |
|---|
| 00409-1390-51 | 0409-1390-51 | 10 VIAL in 1 CARTON (0409-1390-51) / 10 mL in 1 VIAL (0409-1390-21) | 500 mg/10mLInjection, Powder, For Solution | Hospira, Inc. | J2185 · 50 units | Listed |
|---|
| 00409-1391-22 | 0409-1391-22 | 10 VIAL in 1 CARTON (0409-1391-22) / 20 mL in 1 VIAL (0409-1391-21) | 1 g/20mLInjection, Powder, For Solution | Hospira, Inc. | J2185 · 100 units | Listed |
|---|
| 00409-3412-10 | 0409-3412-10 | 10 VIAL in 1 CARTON (0409-3412-10) / 20 mL in 1 VIAL (0409-3412-01) | 1 g/20mLInjection, Powder, For Solution | Hospira, Inc. | J2185 · 100 units | Listed |
|---|
| 00409-3506-01 | 0409-3506-01 | 25 VIAL in 1 CARTON (0409-3506-01) / 20 mL in 1 VIAL (0409-3506-11) | — | Hospira, Inc. | J2185 · 250 units (Q3 2022) | Discontinued by the firm (D) |
|---|
| 00781-3000-95 | 0781-3000-95 | 10 VIAL in 1 CARTON (0781-3000-95) / 20 mL in 1 VIAL (0781-3000-94) | 500 mg/20mLInjection | Sandoz Inc | J2185 · 50 units | Listed |
|---|
| 00781-3000-96 | 0781-3000-96 | 25 VIAL in 1 CARTON (0781-3000-96) / 20 mL in 1 VIAL (0781-3000-94) | 500 mg/20mLInjection | Sandoz Inc | J2185 · 125 units (Q2 2022) | Listed |
|---|
| 00781-3098-95 | 0781-3098-95 | 10 VIAL in 1 CARTON (0781-3098-95) / 30 mL in 1 VIAL (0781-3098-94) | 1 g/30mLInjection | Sandoz Inc | J2185 · 100 units | Listed |
|---|
| 00781-3098-96 | 0781-3098-96 | 25 VIAL in 1 CARTON (0781-3098-96) / 30 mL in 1 VIAL (0781-3098-94) | 1 g/30mLInjection | Sandoz Inc | J2185 · 250 units (Q2 2022) | Listed |
|---|
| 25021-0155-15 | 25021-155-15 | 10 VIAL in 1 CARTON (25021-155-15) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL | — | Sagent Pharmaceuticals | J2185 · 50 units (Q3 2022) | Discontinued by the firm (D) |
|---|
| 25021-0156-30 | 25021-156-30 | 10 VIAL in 1 CARTON (25021-156-30) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL | — | Sagent Pharmaceuticals | J2185 · 100 units (Q3 2022) | Discontinued by the firm (D) |
|---|
| 25021-0160-20 | 25021-160-20 | 10 VIAL in 1 CARTON (25021-160-20) / 20 mL in 1 VIAL | 500 mg/20mLInjection, Powder, For Solution | Sagent Pharmaceuticals | J2185 · 50 units | Listed |
|---|
| 25021-0161-30 | 25021-161-30 | 10 VIAL in 1 CARTON (25021-161-30) / 30 mL in 1 VIAL | 1 g/30mLInjection, Powder, For Solution | Sagent Pharmaceuticals | Not in CMS crosswalk | Listed |
|---|
| 44567-0145-10 | 44567-145-10 | 10 VIAL in 1 CARTON (44567-145-10) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL (44567-145-01) | 500 mg/1Injection, Powder, For Solution | WG Critical Care, LLC | J2185 · 50 units | Listed |
|---|
| 44567-0146-10 | 44567-146-10 | 10 VIAL in 1 CARTON (44567-146-10) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL (44567-146-01) | 1 g/1Injection, Powder, For Solution | WG Critical Care, LLC | J2185 · 100 units | Listed |
|---|
| 44567-0400-10 | 44567-400-10 | 10 VIAL in 1 CARTON (44567-400-10) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL (44567-400-01) | 500 mg/1Injection, Powder, For Solution | WG Critical Care, LLC | J2185 · 50 units | Listed |
|---|
| 44567-0401-10 | 44567-401-10 | 10 VIAL in 1 CARTON (44567-401-10) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL (44567-401-01) | 1 g/1Injection, Powder, For Solution | WG Critical Care, LLC | J2185 · 100 units | Listed |
|---|
| 44567-0402-06 | 44567-402-06 | 6 VIAL in 1 CARTON (44567-402-06) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL (44567-402-01) | 2 g/1Injection, Powder, For Solution | WG Critical Care, LLC | J2183 · 120 units | Listed |
|---|
| 44647-0032-10 | 44647-032-10 | 10 VIAL in 1 CARTON (44647-032-10) / 20 mL in 1 VIAL (44647-032-01) | 500 mg/20mLInjection | Savior Lifetec Corporation | Not in CMS crosswalk | Listed |
|---|
| 44647-0033-10 | 44647-033-10 | 10 VIAL in 1 CARTON (44647-033-10) / 30 mL in 1 VIAL (44647-033-01) | 1 g/30mLInjection | Savior Lifetec Corporation | Not in CMS crosswalk | Listed |
|---|
| 51810-0502-02 | 51810-502-02 | 10 VIAL in 1 CARTON (51810-502-02) / 20 mL in 1 VIAL (51810-502-01) | 500 mg/20mLInjection | Qilu Antibiotics Pharmaceutical Co., Ltd. | Not in CMS crosswalk | Listed |
|---|
| 51810-0503-02 | 51810-503-02 | 10 VIAL in 1 CARTON (51810-503-02) / 30 mL in 1 VIAL (51810-503-01) | 1 g/30mLInjection | Qilu Antibiotics Pharmaceutical Co., Ltd. | Not in CMS crosswalk | Listed |
|---|
| 55150-0207-20 | 55150-207-20 | 10 VIAL in 1 CARTON (55150-207-20) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL | 500 mg/1Injection, Powder, For Solution | Eugia US LLC | J2185 · 50 units | Listed |
|---|
| 55150-0208-30 | 55150-208-30 | 10 VIAL in 1 CARTON (55150-208-30) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL | 1 g/1Injection, Powder, For Solution | Eugia US LLC | J2185 · 100 units | Listed |
|---|
| 63323-0507-20 | 63323-507-20 | 10 VIAL in 1 CARTON (63323-507-20) / 10 mL in 1 VIAL (63323-507-01) | 500 mg/10mLInjection, Powder, For Solution | Fresenius Kabi USA, LLC | J2185 · 50 units | Listed |
|---|
| 63323-0507-21 | 63323-507-21 | 10 VIAL in 1 CARTON (63323-507-21) / 10 mL in 1 VIAL (63323-507-19) | 500 mg/10mLInjection, Powder, For Solution | Fresenius Kabi USA, LLC | J2185 · 50 units | Listed |
|---|
| 63323-0507-25 | 63323-507-25 | 25 VIAL in 1 CARTON (63323-507-25) / 10 mL in 1 VIAL (63323-507-43) | 500 mg/10mLInjection, Powder, For Solution | Fresenius Kabi USA, LLC | J2185 · 125 units | Listed |
|---|
| 63323-0508-25 | 63323-508-25 | 25 VIAL in 1 CARTON (63323-508-25) / 20 mL in 1 VIAL (63323-508-45) | 1 g/20mLInjection, Powder, For Solution | Fresenius Kabi USA, LLC | J2185 · 250 units | Listed |
|---|
| 63323-0508-30 | 63323-508-30 | 10 VIAL in 1 CARTON (63323-508-30) / 20 mL in 1 VIAL (63323-508-01) | 1 g/20mLInjection, Powder, For Solution | Fresenius Kabi USA, LLC | J2185 · 100 units | Listed |
|---|
| 63323-0508-31 | 63323-508-31 | 10 VIAL in 1 CARTON (63323-508-31) / 20 mL in 1 VIAL (63323-508-21) | 1 g/20mLInjection, Powder, For Solution | Fresenius Kabi USA, LLC | J2185 · 100 units | Listed |
|---|
| 68001-0323-31 | 68001-323-31 | 10 VIAL, GLASS in 1 CARTON (68001-323-31) / 20 mL in 1 VIAL, GLASS (68001-323-29) | 500 mg/20mLInjection, Powder, For Solution | BluePoint Laboratories | J2185 · 50 units (Q2 2022) | Discontinued by the firm (D) |
|---|
| 68001-0324-57 | 68001-324-57 | 10 VIAL, GLASS in 1 CARTON (68001-324-57) / 30 mL in 1 VIAL, GLASS (68001-324-58) | 1 g/30mLInjection, Powder, For Solution | BluePoint Laboratories | J2185 · 100 units (Q1 2023) | Discontinued by the firm (D) |
|---|
| 68001-0446-31 | 68001-446-31 | 10 VIAL in 1 CARTON (68001-446-31) / 20 mL in 1 VIAL (68001-446-29) | — | BluePoint Laboratories | J2185 · 50 units (Q2 2024) | Discontinued by the firm (D) |
|---|
| 68001-0447-57 | 68001-447-57 | 10 VIAL in 1 CARTON (68001-447-57) / 30 mL in 1 VIAL (68001-447-58) | — | BluePoint Laboratories | J2185 · 100 units (Q4 2024) | Discontinued by the firm (D) |
|---|
| 68083-0146-10 | 68083-146-10 | 10 VIAL in 1 CARTON (68083-146-10) / 20 mL in 1 VIAL | 500 mg/20mLInjection | Gland Pharma Limited | Not in CMS crosswalk | Listed |
|---|
| 68083-0147-10 | 68083-147-10 | 10 VIAL in 1 CARTON (68083-147-10) / 30 mL in 1 VIAL | 1 g/30mLInjection | Gland Pharma Limited | Not in CMS crosswalk | Listed |
|---|
| 70121-1453-07 | 70121-1453-7 | 10 VIAL, GLASS in 1 CARTON (70121-1453-7) / 30 mL in 1 VIAL, GLASS (70121-1453-1) | 1 g/30mLInjection, Powder, For Solution | Amneal Pharmaceuticals LLC | J2185 · 100 units | Listed |
|---|
| 70121-1454-07 | 70121-1454-7 | 10 VIAL, GLASS in 1 CARTON (70121-1454-7) / 20 mL in 1 VIAL, GLASS (70121-1454-1) | 500 mg/20mLInjection, Powder, For Solution | Amneal Pharmaceuticals LLC | J2185 · 50 units | Listed |
|---|
| 70594-0075-02 | 70594-075-02 | 10 VIAL, GLASS in 1 CARTON (70594-075-02) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, GLASS (70594-075-01) | 500 mg/1Injection, Powder, For Solution | Xellia Pharmaceuticals USA LLC | J2185 · 50 units | Listed |
|---|
| 70594-0076-02 | 70594-076-02 | 10 VIAL, GLASS in 1 CARTON (70594-076-02) / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, GLASS (70594-076-01) | 1 g/1Injection, Powder, For Solution | Xellia Pharmaceuticals USA LLC | J2185 · 100 units | Listed |
|---|
| 72078-0081-06 | 72078-081-06 | 6 INJECTION in 1 CARTON (72078-081-06) | 2 g/1Injection | Mylan Institutional LLC | J2183 · 120 units | Listed |
|---|
| 72485-0411-01 | 72485-411-01 | 1 VIAL in 1 CARTON (72485-411-01) / 20 mL in 1 VIAL | 500 mg/20mLInjection | ARMAS PHARMACEUTICALS INC | Not in CMS crosswalk | Listed |
|---|
| 72485-0411-10 | 72485-411-10 | 10 VIAL in 1 CARTON (72485-411-10) / 20 mL in 1 VIAL | 500 mg/20mLInjection | ARMAS PHARMACEUTICALS INC | J2185 · 50 units | Listed |
|---|
| 72485-0411-25 | 72485-411-25 | 25 VIAL in 1 CARTON (72485-411-25) / 20 mL in 1 VIAL | 500 mg/20mLInjection | ARMAS PHARMACEUTICALS INC | Not in CMS crosswalk | Listed |
|---|
| 72485-0412-01 | 72485-412-01 | 1 VIAL in 1 CARTON (72485-412-01) / 20 mL in 1 VIAL | 1 g/20mLInjection | ARMAS PHARMACEUTICALS INC | Not in CMS crosswalk | Listed |
|---|
| 72485-0412-10 | 72485-412-10 | 10 VIAL in 1 CARTON (72485-412-10) / 20 mL in 1 VIAL | 1 g/20mLInjection | ARMAS PHARMACEUTICALS INC | J2185 · 100 units | Listed |
|---|
| 72485-0412-25 | 72485-412-25 | 25 VIAL in 1 CARTON (72485-412-25) / 20 mL in 1 VIAL | 1 g/20mLInjection | ARMAS PHARMACEUTICALS INC | Not in CMS crosswalk | Listed |
|---|
| 72572-0410-10 | 72572-410-10 | 10 VIAL in 1 CARTON (72572-410-10) / 20 mL in 1 VIAL | 1 g/20mLInjection | Civica, Inc. | J2185 · 100 units | Listed |
|---|
| 72572-0412-10 | 72572-412-10 | 10 VIAL in 1 CARTON (72572-412-10) / 20 mL in 1 VIAL | 500 mg/20mLInjection | Civica, Inc. | J2185 · 50 units | Listed |
|---|
| 72572-0415-10 | 72572-415-10 | 10 VIAL in 1 CARTON (72572-415-10) / 20 mL in 1 VIAL (72572-415-01) | 500 mg/20mLInjection | Civica, Inc | J2185 · 50 units | Listed |
|---|
| 72572-0416-10 | 72572-416-10 | 10 VIAL in 1 CARTON (72572-416-10) / 30 mL in 1 VIAL (72572-416-01) | 1 g/30mLInjection | Civica, Inc | J2185 · 100 units | Listed |
|---|
| 81962-0000-01 | 81962-000-01 | 1 VIAL in 1 CARTON (81962-000-01) / 20 mL in 1 VIAL | 500 mg/20mLInjection | BROOKS STERISCIENCE LIMITED | Not in CMS crosswalk | Listed |
|---|
| 81962-0000-02 | 81962-000-02 | 10 VIAL in 1 CARTON (81962-000-02) / 20 mL in 1 VIAL | 500 mg/20mLInjection | BROOKS STERISCIENCE LIMITED | Not in CMS crosswalk | Listed |
|---|
| 81962-0000-03 | 81962-000-03 | 25 VIAL in 1 CARTON (81962-000-03) / 20 mL in 1 VIAL | 500 mg/20mLInjection | BROOKS STERISCIENCE LIMITED | Not in CMS crosswalk | Listed |
|---|
| 81962-0001-01 | 81962-001-01 | 1 VIAL in 1 CARTON (81962-001-01) / 20 mL in 1 VIAL | 1 g/20mLInjection | BROOKS STERISCIENCE LIMITED | Not in CMS crosswalk | Listed |
|---|
| 81962-0001-02 | 81962-001-02 | 10 VIAL in 1 CARTON (81962-001-02) / 20 mL in 1 VIAL | 1 g/20mLInjection | BROOKS STERISCIENCE LIMITED | Not in CMS crosswalk | Listed |
|---|
| 81962-0001-03 | 81962-001-03 | 25 VIAL in 1 CARTON (81962-001-03) / 20 mL in 1 VIAL | 1 g/20mLInjection | BROOKS STERISCIENCE LIMITED | Not in CMS crosswalk | Listed |
|---|
| 81962-0002-08 | 81962-002-08 | 6 INJECTION in 1 CARTON (81962-002-08) | 2 g/1Injection | BROOKS STERISCIENCE LIMITED | Not in CMS crosswalk | Listed |
|---|
Source
| — |
| Q3 2026 | Jul 1, 2026 – Sep 30, 2026 | $1.408 | 100 MG | 20% | −4.6% | — |
|---|
| Q2 2026 | Apr 1, 2026 – Jun 30, 2026 | $1.476 | 100 MG | 20% | −6.1% | — |
|---|
| Q1 2026 | Jan 1, 2026 – Mar 31, 2026 | $1.572 | 100 MG | 20% | −3.0% | — |
|---|
| Q4 2025 | Oct 1, 2025 – Dec 31, 2025 | $1.620 | 100 MG | 20% | −0.2% | — |
|---|
| Q3 2025 | Jul 1, 2025 – Sep 30, 2025 | $1.624 | 100 MG | 20% | +1.2% | — |
|---|
| Q2 2025 | Apr 1, 2025 – Jun 30, 2025 | $1.604 | 100 MG | 20% | −3.0% | — |
|---|
| Q1 2025 | Jan 1, 2025 – Mar 31, 2025 | $1.654 | 100 MG | 20% | +2.3% | — |
|---|
| Q4 2024 | Oct 1, 2024 – Dec 31, 2024 | $1.617 | 100 MG | 20% | +1.0% | — |
|---|
| Q3 2024 | Jul 1, 2024 – Sep 30, 2024 | $1.601 | 100 MG | 20% | — | Added July 2024 |
|---|
| Quarter | Effective | Payment limit | Per (billing unit) | Coinsurance | Change | CMS notes |
|---|---|---|---|---|---|---|
| Q4 2026 | Oct 1, 2026 – Dec 31, 2026 | $0.358 | 100 MG | 20% | +10.2% | — |
| Q3 2026 | Jul 1, 2026 – Sep 30, 2026 | $0.325 | 100 MG | 20% | −12.4% | — |
| Q2 2026 | Apr 1, 2026 – Jun 30, 2026 | $0.371 | 100 MG | 20% | −3.1% | — |
| Q1 2026 | Jan 1, 2026 – Mar 31, 2026 | $0.383 | 100 MG | 20% | −9.0% | — |
| Q4 2025 | Oct 1, 2025 – Dec 31, 2025 | $0.421 | 100 MG | 20% | −3.4% | — |
| Q3 2025 | Jul 1, 2025 – Sep 30, 2025 | $0.436 | 100 MG | 20% | +1.2% | — |
| Q2 2025 | Apr 1, 2025 – Jun 30, 2025 | $0.431 | 100 MG | 20% | +11.1% | — |
| Q1 2025 | Jan 1, 2025 – Mar 31, 2025 | $0.388 | 100 MG | 20% | +9.6% | — |
| Q4 2024 | Oct 1, 2024 – Dec 31, 2024 | $0.354 | 100 MG | 20% | +10.3% | — |
| Q3 2024 | Jul 1, 2024 – Sep 30, 2024 | $0.321 | 100 MG | 20% | −17.1% | — |
| Q2 2024 | Apr 1, 2024 – Jun 30, 2024 | $0.387 | 100 MG | 20% | −14.4% | — |
| Q1 2024 | Jan 1, 2024 – Mar 31, 2024 | $0.452 | 100 MG | 20% | −19.6% | — |
| Q4 2023 | Oct 1, 2023 – Dec 31, 2023 | $0.562 | 100 MG | 20% | +8.5% | AMP-based payment limit |
| Q3 2023 | Jul 1, 2023 – Sep 30, 2023 | $0.518 | 100 MG | 20% | +4.6% | AMP-based payment limit |
| Q2 2023 | Apr 1, 2023 – Jun 30, 2023 | $0.495 | 100 MG | 20% | −20.3% | AMP-based payment limit |
| Q1 2023 | Jan 1, 2023 – Mar 31, 2023 | $0.621 | 100 MG | — | −14.3% | — |
| Q4 2022 | Oct 1, 2022 – Dec 31, 2022 | $0.725 | 100 MG | — | +3.7% | — |
| Q3 2022 | Jul 1, 2022 – Sep 30, 2022 | $0.699 | 100 MG | — | +0.9% | — |
| Q2 2022 | Apr 1, 2022 – Jun 30, 2022 | $0.693 | 100 MG | — | −6.7% | — |
| Q1 2022 | Jan 1, 2022 – Mar 31, 2022 | $0.743 | 100 MG | — | −6.4% | — |
| Q4 2021 | Oct 1, 2021 – Dec 31, 2021 | $0.794 | 100 MG | — | −3.1% | — |
| Q3 2021 | Jul 1, 2021 – Sep 30, 2021 | $0.819 | 100 MG | — | +4.3% | — |
| Q2 2021 | Apr 1, 2021 – Jun 30, 2021 | $0.785 | 100 MG | — | +2.9% | — |
| Q1 2021 | Jan 1, 2021 – Mar 31, 2021 | $0.763 | 100 MG | — | — | — |
| 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.
| Change |
|---|
| CMS action code |
|---|
| Details |
|---|
| Q1 2023 | In earliest ingested file | N — No maintenance | Added date Jan 1, 2004 |
|---|
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 |
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| A4232 | Syringe w/needle insulin 3cc | $79.14 | N/A | — | See Home Infusion & Parenteral Nutrition Billing Guide for Details |
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| A4238 | Adju cgm supply allowance | $270.89 | N/A | EPA | Invoice Required/See Home Infusion & Parenteral Nutrition Billing Guide for Details |
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| A4239 | Non-adju cgm supply allow | $263.72 | N/A | EPA | Limit: 1 unit/month - See Home Infusion & Parenteral Nutrition Billing Guide for Details |
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| A4246 | Betadine/phisohex solution | $2.87 | N/A | — | See Home Infusion & Parenteral Nutrition Billing Guide for Details |
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| A4247 | Betadine/iodine swabs/wipes | $4.55 | N/A | — | See Home Infusion & Parenteral Nutrition Billing Guide for Details |
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| A4602 | Replace lithium battery 1.5v | $5.31 | N/A | — | See Home Infusion & Parenteral Nutrition Billing Guide for Details |
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| A4927 | Non-sterile gloves | DP | N/A | PA - Exceptions to Max | Please see Medical Equipment Fee Schedule for rates |
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| A4930 | Sterile, gloves per pair | DP | N/A | — | Please see Medical Equipment Fee Schedule for rates |
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| A9276 | Disposable sensor, cgm sys | BR | N/A | PA/EPA | Invoice Required/See Home Infusion & Parenteral Nutrition Billing Guide for Details |
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| A9277 | External transmitter, cgm | BR | N/A | PA/EPA | invoice required |
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| A9278 | External receiver, cgm sys | BR | N/A | PA/EPA | Invoice Required/See Home Infusion & Parenteral Nutrition Billing Guide for Details |
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| B4164 | Parenteral 50% dextrose solu | $18.8947 | N/A | — | — |
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| B4168 | Parenteral sol amino acid 3. | $27.5508 | N/A | — | — |
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| B4172 | Parenteral sol amino acid 5. | $31.74 | N/A | — | — |
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| B4176 | Parenteral sol amino acid 7- | $53.3162 | N/A | — | — |
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| B4178 | Parenteral sol amino acid > | $63.9988 | N/A | — | — |
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| B4180 | Parenteral sol carb > 50% | $27.1261 | N/A | — | — |
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| B4185 | Pn soln nos 10 grams lipids | $12.4967 | N/A | — | — |
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| 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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