J0167 HCPCS code: Injection, epinephrine (hospira), not therapeutically equivalent to j0165, 0.1 mg
J0167 is the HCPCS Level II code for injection, epinephrine (hospira), not therapeutically equivalent to j0165, 0.1 mg. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. The NCCI unit limit is 120 per day on outpatient hospital claims.
Code details
| Field | Value |
|---|---|
| Section | J codes — Drugs administered other than oral method |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 51 — Drug or biological (priced per ASP/average sales price rules) |
| BETOS category | O1E — Other drugs |
| Added | 2025-07-01 |
| Last action effective | 2025-07-01 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 120 | Prescribing Information |
| practitioner claims | 20 | Prescribing Information |
What changed for J0167
- October 2025: Code appears in this HCPCS release
- 2025-07-01: J0167 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 J0167?
J0167 is the HCPCS Level II code for injection, epinephrine (hospira), not therapeutically equivalent to j0165, 0.1 mg. Short descriptor: "Inj epinephrine (hospira)".
Does Medicare cover J0167?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of J0167 can be billed per day?
120 on outpatient hospital claims; 20 on practitioner claims (NCCI medically unlikely edits).
Related J01 codes
- J0120 — Injection, tetracycline, up to 250 mg
- J0121 — Injection, omadacycline, 1 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
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Next steps
- Run a reimbursement report for a device billed under J0167
- Watch J0167 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J0167
Sources: CMS HCPCS Level II release October 2025; 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.