J0121 HCPCS code: Injection, omadacycline, 1 mg
J0121 is the HCPCS Level II code for injection, omadacycline, 1 mg. In 2024 Medicare paid an average of $2.96 per service for J0121 across 858,861 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 200 per day on outpatient hospital claims. Medicare volume rose 90% from 2022 to 2024 (452,931 to 858,861 services). In 2024, about 111 clinicians billed Medicare for J0121 for 413 beneficiaries; Florida, Texas, Georgia accounted for 90% of services.
Code details
| Field | Value |
|---|---|
| Section | J codes — Drugs administered other than oral method |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 51 — Drug or biological (priced per ASP/average sales price rules) |
| BETOS category | O1E — Other drugs |
| Added | 2019-10-01 |
| Last action effective | 2019-10-01 |
Who bills J0121 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 111 |
| Medicare beneficiaries | 413 |
| States with claims | 5 |
| Share of services in top 3 states (Florida, Texas, Georgia) | 90% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J0121, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 452,931 | 297 | $3.32 | $2.65 |
| 2023 | 563,567 | 356 | $3.59 | $2.85 |
| 2024 | 858,861 | 413 | $3.72 | $2.96 |
States with the most J0121 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 404,342 | $2.96 |
| Texas | 162,009 | $2.95 |
| Georgia | 148,000 | $2.96 |
| Michigan | 44,302 | $3.00 |
| Indiana | 36,100 | $2.96 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 200 | Prescribing Information |
| practitioner claims | 200 | Prescribing Information |
What changed for J0121
- 2019-10-01: J0121 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code J0121?
J0121 is the HCPCS Level II code for injection, omadacycline, 1 mg. Short descriptor: "Inj., omadacycline, 1 mg".
How much does Medicare pay for J0121?
In 2024, the average Medicare payment was $2.96 per service (average allowed $3.72).
Does Medicare cover J0121?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J0121 can be billed per day?
200 on outpatient hospital claims; 200 on practitioner claims (NCCI medically unlikely edits).
Related J01 codes
- J0120 — Injection, tetracycline, up to 250 mg
- J0122 — Injection, eravacycline, 1 mg
- J0129 — Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)
- J0130 — Injection abciximab, 10 mg
- J0131 — Injection, acetaminophen, not otherwise specified,10 mg
- J0132 — Injection, acetylcysteine, 100 mg
- J0133 — Injection, acyclovir, 5 mg
- J0134 — Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg
- J0135 — Injection, adalimumab, 20 mg
- J0136 — Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg
- J0137 — Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg
- J0138 — Injection, acetaminophen 10 mg and ibuprofen 3 mg
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under J0121
- Watch J0121 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J0121
Sources: CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.