J1020 HCPCS code: Injection, methylprednisolone acetate, 20 mg
J1020 is the HCPCS Level II code for injection, methylprednisolone acetate, 20 mg. CMS terminated J1020 on 2024-03-31; do not bill it for later dates of service. In 2024 Medicare paid an average of $4.57 per service for J1020 across 40,745 services. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. Medicare volume fell 75% from 2022 to 2024 (164,915 to 40,745 services). In 2024, about 3,228 clinicians billed Medicare for J1020 for 19,199 beneficiaries; Illinois, California, Texas accounted for 42% 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 | 1982-01-01 |
| Last action effective | 2024-04-01 |
| Terminated | 2024-03-31 |
Who bills J1020 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 3,228 |
| Medicare beneficiaries | 19,199 |
| States with claims | 48 |
| Share of services in top 3 states (Illinois, California, Texas) | 42% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J1020, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 164,915 | 62,993 | $3.14 | $2.36 |
| 2023 | 171,141 | 62,155 | $5.60 | $4.31 |
| 2024 | 40,745 | 19,199 | $6.68 | $4.57 |
States with the most J1020 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Illinois | 10,768 | $5.36 |
| California | 3,692 | $5.05 |
| Texas | 2,805 | $3.70 |
| Florida | 2,524 | $4.51 |
| New York | 1,715 | $4.38 |
What changed for J1020
- 1982-01-01: J1020 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 J1020?
J1020 is the HCPCS Level II code for injection, methylprednisolone acetate, 20 mg. Short descriptor: "Methylprednisolone 20 mg inj".
How much does Medicare pay for J1020?
In 2024, the average Medicare payment was $4.57 per service (average allowed $6.68).
Does Medicare cover J1020?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Related J10 codes
- J1000 — Injection, depo-estradiol cypionate, up to 5 mg
- J1010 — Injection, methylprednisolone acetate, 1 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 J1020
- Watch J1020 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J1020
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.