J0604 HCPCS code: Cinacalcet, oral, 1 mg, (for esrd on dialysis)
J0604 is the HCPCS Level II code for cinacalcet, oral, 1 mg, (for esrd on dialysis). Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met.
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 | 2018-01-01 |
| Last action effective | 2018-01-01 |
What changed for J0604
- 2018-01-01: J0604 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 J0604?
J0604 is the HCPCS Level II code for cinacalcet, oral, 1 mg, (for esrd on dialysis). Short descriptor: "Cinacalcet, esrd on dialysis".
Does Medicare cover J0604?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Related J06 codes
- J0600 — Injection, edetate calcium disodium, up to 1000 mg
- J0601 — Sevelamer carbonate (renvela or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)
- J0602 — Sevelamer carbonate (renvela or therapeutically equivalent), oral, powder, 20 mg (for esrd on dialysis)
- J0603 — Sevelamer hydrochloride (renagel or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)
- J0605 — Sucroferric oxyhydroxide, oral, 5 mg (for esrd on dialysis)
- J0606 — Injection, etelcalcetide, 0.1 mg
- J0607 — Lanthanum carbonate, oral, 5 mg (for esrd on dialysis)
- J0608 — Lanthanum carbonate, oral, powder, 5 mg, not therapeutically equivalent to j0607 (for esrd on dialysis)
- J0609 — Ferric citrate, oral, 3 mg ferric iron, (for esrd on dialysis)
- J0610 — Injection, calcium gluconate (fresenius kabi), per 10 ml
- J0611 — Injection, calcium gluconate (wg critical care), per 10 ml
- J0612 — Injection, calcium gluconate, not otherwise specified, 10 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 J0604
- Watch J0604 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J0604
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.