J0587 HCPCS code: Injection, rimabotulinumtoxinb, 100 units
J0587 is the HCPCS Level II code for injection, rimabotulinumtoxinb, 100 units. In 2024 Medicare paid an average of $9.97 per service for J0587 across 401,788 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 300 per day on outpatient hospital claims. Medicare volume fell 9% from 2022 to 2024 (439,302 to 401,788 services). In 2024, about 673 clinicians billed Medicare for J0587 for 2,447 beneficiaries; Texas, Florida, New York accounted for 34% of services.
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 | 2002-01-01 |
| Last action effective | 2010-01-01 |
Who bills J0587 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 673 |
| Medicare beneficiaries | 2,447 |
| States with claims | 31 |
| Share of services in top 3 states (Texas, Florida, New York) | 34% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J0587, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 439,302 | 2,690 | $11.92 | $9.44 |
| 2023 | 410,477 | 2,573 | $12.38 | $9.79 |
| 2024 | 401,788 | 2,447 | $12.60 | $9.97 |
States with the most J0587 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Texas | 54,476 | $10.07 |
| Florida | 45,374 | $10.12 |
| New York | 34,147 | $10.14 |
| California | 31,609 | $9.96 |
| Illinois | 23,442 | $9.91 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 300 | Clinical: Data |
| practitioner claims | 300 | Clinical: Data |
Medicare policy articles for this code
- A57114: Billing and Coding: Trigger Point Injections (First Coast Service Options, Inc. (MAC - Part B))
- A57185: Billing and Coding: Botulinum Toxin Injections (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B))
- A57186: Billing and Coding: Botulinum Toxin Injections (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B))
- A57715: Billing and Coding: Botulinum Toxins (First Coast Service Options, Inc. (MAC - Part A, MAC - Part B))
- A57751: Billing and Coding: Trigger Point Injections (Novitas Solutions, Inc. (MAC - Part A, MAC - Part B))
- A58423: Billing and Coding: Botulinum Toxins (Novitas Solutions, Inc. (MAC - Part A, MAC - Part B))
- A59707: Billing and Coding: Botulinum Toxin Injections (Wellpoint Federal (MAC - Part A, MAC - Part B))
- A59714: Billing and Coding: Botulinum Toxin Injections (Palmetto GBA (MAC - Part A, MAC - Part B))
- A59726: Billing and Coding: Botulinum Toxins Injections (CGS Administrators, LLC (MAC - Part A, MAC - Part B))
- A59809: Billing and Coding: Botulinum Toxin Injections (WPS Insurance Corporation (MAC - Part A, MAC - Part B))
Covered diagnoses (346 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| G11.4 | Hereditary spastic paraplegia | 8 |
| G24.3 | Spasmodic torticollis | 8 |
| G24.4 | Idiopathic orofacial dystonia | 8 |
| G24.5 | Blepharospasm | 8 |
| G24.8 | Other dystonia | 8 |
| G25.0 | Essential tremor | 8 |
| G43.701 | Chronic migraine without aura, not intractable, with status migrainosus | 8 |
| G43.709 | Chronic migraine without aura, not intractable, without status migrainosus | 8 |
| G43.711 | Chronic migraine without aura, intractable, with status migrainosus | 8 |
| G43.719 | Chronic migraine without aura, intractable, without status migrainosus | 8 |
Showing 10 of 346. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for J0587
- 2002-01-01: J0587 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 J0587?
J0587 is the HCPCS Level II code for injection, rimabotulinumtoxinb, 100 units. Short descriptor: "Inj, rimabotulinumtoxinb".
How much does Medicare pay for J0587?
In 2024, the average Medicare payment was $9.97 per service (average allowed $12.60).
Does Medicare cover J0587?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Which diagnoses support coverage for J0587?
Medicare policy articles that cite J0587 list 346 covered ICD-10-CM diagnosis codes across 10 articles. The most cited include G11.4 (Hereditary spastic paraplegia), G24.3 (Spasmodic torticollis), G24.4 (Idiopathic orofacial dystonia). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
How many units of J0587 can be billed per day?
300 on outpatient hospital claims; 300 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
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Next steps
- Run a reimbursement report for a device billed under J0587
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- Build a full Medicare revenue model for J0587
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.