J0515 HCPCS code: Injection, benztropine mesylate, per 1 mg
J0515 is the HCPCS Level II code for injection, benztropine mesylate, per 1 mg. In 2023 Medicare paid an average of $12.14 per service for J0515 across 108 services. 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 6 per day on outpatient hospital claims. Medicare volume fell 54% from 2022 to 2023 (237 to 108 services). In 2023, about 17 clinicians billed Medicare for J0515 for 12 beneficiaries.
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 | 1982-01-01 |
| Last action effective | 1997-01-01 |
Who bills J0515 (2023)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 17 |
| Medicare beneficiaries | 12 |
| States with claims | 0 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J0515, 2022–2023
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 237 | 17 | $16.37 | $11.90 |
| 2023 | 108 | 12 | $16.79 | $12.14 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 6 | Clinical: Data |
| practitioner claims | 3 | Clinical: Data |
What changed for J0515
- 1982-01-01: J0515 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 J0515?
J0515 is the HCPCS Level II code for injection, benztropine mesylate, per 1 mg. Short descriptor: "Inj benztropine mesylate".
How much does Medicare pay for J0515?
In 2023, the average Medicare payment was $12.14 per service (average allowed $16.79).
Does Medicare cover J0515?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of J0515 can be billed per day?
6 on outpatient hospital claims; 3 on practitioner claims (NCCI medically unlikely edits).
Related J05 codes
- J0500 — Injection, dicyclomine hcl, up to 20 mg
- J0517 — Injection, benralizumab, 1 mg
- J0520 — Injection, bethanechol chloride, myotonachol or urecholine, up to 5 mg
- J0525 — Injection, cefotetan disodium, 10 mg
- J0558 — Injection, penicillin g benzathine and penicillin g procaine, 100,000 units
- J0561 — Injection, penicillin g benzathine, 100,000 units
- J0565 — Injection, bezlotoxumab, 10 mg
- J0567 — Injection, cerliponase alfa, 1 mg
- J0570 — Buprenorphine implant, 74.2 mg
- J0571 — Buprenorphine, oral, 1 mg
- J0572 — Buprenorphine/naloxone, oral, less than or equal to 3 mg buprenorphine
- J0573 — Buprenorphine/naloxone, oral, greater than 3 mg, but less than or equal to 6 mg buprenorphine
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 J0515
- Watch J0515 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J0515
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.