J0894 HCPCS code: Injection, decitabine, 1 mg
J0894 is the HCPCS Level II code for injection, decitabine, 1 mg. In 2024 Medicare paid an average of $1.24 per service for J0894 across 1,234,487 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 100 per day on outpatient hospital claims. Medicare volume fell 22% from 2022 to 2024 (1,585,510 to 1,234,487 services). In 2024, about 2,132 clinicians billed Medicare for J0894 for 1,335 beneficiaries; Florida, California, Arizona accounted for 29% 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 | 2007-01-01 |
| Last action effective | 2023-01-01 |
Who bills J0894 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 2,132 |
| Medicare beneficiaries | 1,335 |
| States with claims | 32 |
| Share of services in top 3 states (Florida, California, Arizona) | 29% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J0894, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 1,585,510 | 1,603 | $2.15 | $1.70 |
| 2023 | 1,394,780 | 1,448 | $1.70 | $1.34 |
| 2024 | 1,234,487 | 1,335 | $1.57 | $1.24 |
States with the most J0894 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 163,624 | $1.25 |
| California | 104,668 | $1.24 |
| Arizona | 68,963 | $1.25 |
| Texas | 66,173 | $1.24 |
| Virginia | 60,211 | $1.23 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 100 | Clinical: Data |
| practitioner claims | 100 | Clinical: Data |
What changed for J0894
- 2007-01-01: J0894 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 J0894?
J0894 is the HCPCS Level II code for injection, decitabine, 1 mg. Short descriptor: "Decitabine injection".
How much does Medicare pay for J0894?
In 2024, the average Medicare payment was $1.24 per service (average allowed $1.57).
Does Medicare cover J0894?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J0894 can be billed per day?
100 on outpatient hospital claims; 100 on practitioner claims (NCCI medically unlikely edits).
Related J08 codes
- J0800 — Injection, corticotropin, up to 40 units
- J0801 — Injection, corticotropin (acthar gel), up to 40 units
- J0802 — Injection, corticotropin (ani), up to 40 units
- J0833 — Injection, cosyntropin, not otherwise specified, 0.25 mg
- J0834 — Injection, cosyntropin, 0.25 mg
- J0840 — Injection, crotalidae polyvalent immune fab (ovine), up to 1 gram
- J0841 — Injection, crotalidae immune f(ab')2 (equine), 120 mg
- J0850 — Injection, cytomegalovirus immune globulin intravenous (human), per vial
- J0870 — Injection, imetelstat, 1 mg
- J0871 — Injection, daptomycin (endo), not therapeutically equivalent to j0878, 1 mg
- J0872 — Injection, daptomycin (xellia), unrefrigerated, not therapeutically equivalent to j0878 or j0873, 1 mg
- J0873 — Injection, daptomycin (xellia), not therapeutically equivalent to j0878 or j0872, 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 J0894
- Watch J0894 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J0894
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.