J0588 HCPCS code: Injection, incobotulinumtoxin a, 1 unit
J0588 is the HCPCS Level II code for injection, incobotulinumtoxin a, 1 unit. In 2024 Medicare paid an average of $4.03 per service for J0588 across 4,041,923 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 600 per day on outpatient hospital claims. Medicare volume rose 31% from 2022 to 2024 (3,092,468 to 4,041,923 services). In 2024, about 1,670 clinicians billed Medicare for J0588 for 9,405 beneficiaries; California, Texas, Florida accounted for 30% of services.
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 | 2012-01-01 |
| Last action effective | 2012-01-01 |
Who bills J0588 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 1,670 |
| Medicare beneficiaries | 9,405 |
| States with claims | 47 |
| Share of services in top 3 states (California, Texas, Florida) | 30% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J0588, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 3,092,468 | 7,330 | $4.94 | $3.92 |
| 2023 | 3,564,451 | 8,324 | $5.04 | $3.99 |
| 2024 | 4,041,923 | 9,405 | $5.09 | $4.03 |
States with the most J0588 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 616,732 | $4.04 |
| Texas | 340,112 | $4.04 |
| Florida | 271,533 | $4.04 |
| New York | 270,896 | $4.04 |
| North Carolina | 170,636 | $4.01 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 600 | Clinical: Data |
| practitioner claims | 600 | 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 J0588
- 2012-01-01: J0588 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 J0588?
J0588 is the HCPCS Level II code for injection, incobotulinumtoxin a, 1 unit. Short descriptor: "Incobotulinumtoxin a".
How much does Medicare pay for J0588?
In 2024, the average Medicare payment was $4.03 per service (average allowed $5.09).
Does Medicare cover J0588?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for J0588?
Medicare policy articles that cite J0588 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 J0588 can be billed per day?
600 on outpatient hospital claims; 600 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 J0588
- Watch J0588 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J0588
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.