J1030 HCPCS code: Injection, methylprednisolone acetate, 40 mg
J1030 is the HCPCS Level II code for injection, methylprednisolone acetate, 40 mg. CMS terminated J1030 on 2024-03-31; do not bill it for later dates of service. In 2024 Medicare paid an average of $3.97 per service for J1030 across 376,370 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 74% from 2022 to 2024 (1,467,075 to 376,370 services). In 2024, about 24,338 clinicians billed Medicare for J1030 for 231,606 beneficiaries; Florida, Texas, California accounted for 28% 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 J1030 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 24,338 |
| Medicare beneficiaries | 231,606 |
| States with claims | 53 |
| Share of services in top 3 states (Florida, Texas, California) | 28% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J1030, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 1,467,075 | 690,899 | $6.32 | $4.77 |
| 2023 | 1,519,574 | 705,301 | $7.50 | $5.64 |
| 2024 | 376,370 | 231,606 | $6.28 | $3.97 |
States with the most J1030 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 49,326 | $4.25 |
| Texas | 29,457 | $3.83 |
| California | 25,559 | $4.38 |
| South Carolina | 20,234 | $3.90 |
| New York | 19,810 | $4.31 |
What changed for J1030
- 1982-01-01: J1030 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 J1030?
J1030 is the HCPCS Level II code for injection, methylprednisolone acetate, 40 mg. Short descriptor: "Methylprednisolone 40 mg inj".
How much does Medicare pay for J1030?
In 2024, the average Medicare payment was $3.97 per service (average allowed $6.28).
Does Medicare cover J1030?
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
- J1020 — Injection, methylprednisolone acetate, 20 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
- J1080 — Injection, testosterone cypionate, 1 cc, 200 mg
- J1094 — Injection, dexamethasone acetate, 1 mg
- J1095 — Injection, dexamethasone 9 percent, intraocular, 1 microgram
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Next steps
- Run a reimbursement report for a device billed under J1030
- Watch J1030 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J1030
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.