J0741 HCPCS code: Injection, cabotegravir and rilpivirine, 2mg/3mg
J0741 is the HCPCS Level II code for injection, cabotegravir and rilpivirine, 2mg/3mg. In 2024 Medicare paid an average of $14.98 per service for J0741 across 267,333 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 300 per day on outpatient hospital claims. Medicare volume rose 161% from 2022 to 2024 (102,377 to 267,333 services). In 2024, about 311 clinicians billed Medicare for J0741 for 328 beneficiaries; California, Florida, Texas accounted for 54% 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 | 2021-10-01 |
| Last action effective | 2021-10-01 |
Who bills J0741 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 311 |
| Medicare beneficiaries | 328 |
| States with claims | 9 |
| Share of services in top 3 states (California, Florida, Texas) | 54% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J0741, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 102,377 | 211 | $17.57 | $13.99 |
| 2023 | 195,103 | 333 | $18.32 | $14.58 |
| 2024 | 267,333 | 328 | $18.85 | $14.98 |
States with the most J0741 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 32,400 | $10.50 |
| Florida | 28,216 | $16.70 |
| Texas | 18,900 | $17.74 |
| Kentucky | 15,104 | $17.46 |
| Georgia | 15,060 | $15.62 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 300 | Prescribing Information |
| practitioner claims | 300 | Prescribing Information |
What changed for J0741
- 2021-10-01: J0741 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 J0741?
J0741 is the HCPCS Level II code for injection, cabotegravir and rilpivirine, 2mg/3mg. Short descriptor: "Inj, cabote rilpivir 2mg 3mg".
How much does Medicare pay for J0741?
In 2024, the average Medicare payment was $14.98 per service (average allowed $18.85).
Does Medicare cover J0741?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J0741 can be billed per day?
300 on outpatient hospital claims; 300 on practitioner claims (NCCI medically unlikely edits).
Related J07 codes
- J0701 — Injection, cefepime hydrochloride (baxter), not therapeutically equivalent to maxipime, 500 mg
- J0702 — Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg
- J0703 — Injection, cefepime hydrochloride (b braun), not therapeutically equivalent to maxipime, 500 mg
- J0706 — Injection, caffeine citrate, 5 mg
- J0710 — Injection, cephapirin sodium, up to 1 gm
- J0712 — Injection, ceftaroline fosamil, 10 mg
- J0713 — Injection, ceftazidime, per 500 mg
- J0714 — Injection, ceftazidime and avibactam, 0.5 g/0.125 g
- J0715 — Injection, ceftizoxime sodium, per 500 mg
- J0716 — Injection, centruroides immune f(ab)2, up to 120 milligrams
- J0717 — Injection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)
- J0720 — Injection, chloramphenicol sodium succinate, up to 1 gm
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Next steps
- Run a reimbursement report for a device billed under J0741
- Watch J0741 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J0741
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.