J0578 HCPCS code: Injection, buprenorphine extended release (brixadi), greater than 7 days and up to 28 days of therapy
J0578 is the HCPCS Level II code for injection, buprenorphine extended release (brixadi), greater than 7 days and up to 28 days of therapy. In 2024 Medicare paid an average of $172.09 per service for J0578 across 30 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 1 per day on DME suppliers. In 2024, about 13 clinicians billed Medicare for J0578 for 16 beneficiaries.
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 | 2024-04-01 |
| Last action effective | 2024-04-01 |
Who bills J0578 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 13 |
| Medicare beneficiaries | 16 |
| States with claims | 0 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J0578, 2024–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2024 | 30 | 16 | $219.90 | $172.09 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 1 | Prescribing Information |
| outpatient hospital claims | 1 | Prescribing Information |
| practitioner claims | 1 | Prescribing Information |
What changed for J0578
- 2024-04-01: J0578 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 J0578?
J0578 is the HCPCS Level II code for injection, buprenorphine extended release (brixadi), greater than 7 days and up to 28 days of therapy. Short descriptor: "Inj brixadi, more than 7 day".
How much does Medicare pay for J0578?
In 2024, the average Medicare payment was $172.09 per service (average allowed $219.90).
Does Medicare cover J0578?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J0578 can be billed per day?
1 on DME suppliers; 1 on outpatient hospital claims; 1 on practitioner claims (NCCI medically unlikely edits).
Related J05 codes
- J0500 — Injection, dicyclomine hcl, up to 20 mg
- J0515 — Injection, benztropine mesylate, per 1 mg
- J0517 — Injection, benralizumab, 1 mg
- J0520 — Injection, bethanechol chloride, myotonachol or urecholine, up to 5 mg
- J0525 — Injection, cefotetan disodium, 10 mg
- J0528 — Injection, fosfomycin disodium, 20 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
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 J0578
- Watch J0578 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J0578
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.