J1010 HCPCS code: Injection, methylprednisolone acetate, 1 mg
J1010 is the HCPCS Level II code for injection, methylprednisolone acetate, 1 mg. In 2024 Medicare paid an average of $0.10 per service for J1010 across 81,048,043 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 160 per day on DME suppliers. In 2024, about 50,292 clinicians billed Medicare for J1010 for 900,419 beneficiaries; Florida, Texas, Tennessee accounted for 24% 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 | 2024-04-01 |
| Last action effective | 2025-01-01 |
Who bills J1010 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 50,292 |
| Medicare beneficiaries | 900,419 |
| States with claims | 55 |
| Share of services in top 3 states (Florida, Texas, Tennessee) | 24% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J1010, 2024–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2024 | 81,048,043 | 900,419 | $0.13 | $0.10 |
States with the most J1010 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 9,062,842 | $0.10 |
| Texas | 6,387,618 | $0.10 |
| Tennessee | 4,192,714 | $0.10 |
| Georgia | 4,155,401 | $0.10 |
| California | 3,954,541 | $0.10 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 160 | Prescribing Information |
| outpatient hospital claims | 160 | Prescribing Information |
| practitioner claims | 160 | Prescribing Information |
Medicare policy articles for this code
- A57114: Billing and Coding: Trigger Point Injections (First Coast Service Options, Inc. (MAC - Part B))
- A57751: Billing and Coding: Trigger Point Injections (Novitas Solutions, Inc. (MAC - Part A, MAC - Part B))
Covered diagnoses (2 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| M79.12 | Myalgia of auxiliary muscles, head and neck | 2 |
| M79.18 | Myalgia, other site | 2 |
What changed for J1010
- 2024-04-01: J1010 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 J1010?
J1010 is the HCPCS Level II code for injection, methylprednisolone acetate, 1 mg. Short descriptor: "Inj, methylpred acetate 1 mg".
How much does Medicare pay for J1010?
In 2024, the average Medicare payment was $0.10 per service (average allowed $0.13).
Does Medicare cover J1010?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Which diagnoses support coverage for J1010?
Medicare policy articles that cite J1010 list 2 covered ICD-10-CM diagnosis codes across 2 articles. The most cited include M79.12 (Myalgia of auxiliary muscles, head and neck), M79.18 (Myalgia, other site). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
How many units of J1010 can be billed per day?
160 on DME suppliers; 160 on outpatient hospital claims; 160 on practitioner claims (NCCI medically unlikely edits).
Related J10 codes
- J1000 — Injection, depo-estradiol cypionate, up to 5 mg
- J1020 — Injection, methylprednisolone acetate, 20 mg
- J1030 — Injection, methylprednisolone acetate, 40 mg
- J1040 — Injection, methylprednisolone acetate, 80 mg
- J1050 — Injection, medroxyprogesterone acetate, 1 mg
- J1060 — Injection, testosterone cypionate and estradiol cypionate, up to 1 ml
- J1070 — Injection, testosterone cypionate, up to 100 mg
- J1071 — Injection, testosterone cypionate, 1 mg
- J1072 — Injection, testosterone cypionate (azmiro), 1 mg
- J1073 — Testosterone pellet, implant, 75 mg
- J1080 — Injection, testosterone cypionate, 1 cc, 200 mg
- J1094 — Injection, dexamethasone acetate, 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 J1010
- Watch J1010 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J1010
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.