J0220 HCPCS code: Injection, alglucosidase alfa, 10 mg, not otherwise specified

J0220 is the HCPCS Level II code for injection, alglucosidase alfa, 10 mg, not otherwise specified. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 20 per day on outpatient hospital claims.

Code details

FieldValue
SectionJ codes — Drugs administered other than oral method
Coverage codeC — Carrier judgment
Pricing indicator51 — Drug or biological (priced per ASP/average sales price rules)
BETOS categoryO1E — Other drugs
Added2008-01-01
Last action effective2012-01-01

NCCI unit limits (MUE)

Claim typeMax units per dayRationale
outpatient hospital claims20Prescribing Information
practitioner claims1Clinical: Data

What changed for J0220

Frequently asked questions

What is HCPCS code J0220?

J0220 is the HCPCS Level II code for injection, alglucosidase alfa, 10 mg, not otherwise specified. Short descriptor: "Alglucosidase alfa injection".

Does Medicare cover J0220?

Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.

How many units of J0220 can be billed per day?

20 on outpatient hospital claims; 1 on practitioner claims (NCCI medically unlikely edits).

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Next steps

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.

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