J1302 HCPCS code: Injection, sutimlimab-jome, 10 mg
J1302 is the HCPCS Level II code for injection, sutimlimab-jome, 10 mg. In 2024 Medicare paid an average of $13.98 per service for J1302 across 783,841 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 770 per day on DME suppliers. Medicare volume rose 1123% from 2022 to 2024 (64,091 to 783,841 services). In 2024, about 205 clinicians billed Medicare for J1302 for 78 beneficiaries.
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 | 2022-10-01 |
| Last action effective | 2022-10-01 |
Who bills J1302 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 205 |
| Medicare beneficiaries | 78 |
| States with claims | 2 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J1302, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 64,091 | 23 | $16.62 | $13.24 |
| 2023 | 519,000 | 54 | $17.19 | $13.70 |
| 2024 | 783,841 | 78 | $17.55 | $13.98 |
States with the most J1302 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 136,630 | $14.07 |
| Texas | 109,450 | $14.07 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 770 | Prescribing Information |
| outpatient hospital claims | 770 | Prescribing Information |
| practitioner claims | 770 | Prescribing Information |
What changed for J1302
- 2022-10-01: J1302 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 J1302?
J1302 is the HCPCS Level II code for injection, sutimlimab-jome, 10 mg. Short descriptor: "Inj, sutimlimab-jome, 10 mg".
How much does Medicare pay for J1302?
In 2024, the average Medicare payment was $13.98 per service (average allowed $17.55).
Does Medicare cover J1302?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J1302 can be billed per day?
770 on DME suppliers; 770 on outpatient hospital claims; 770 on practitioner claims (NCCI medically unlikely edits).
Related J13 codes
- J1300 — Injection, eculizumab, 10 mg
- J1301 — Injection, edaravone, 1 mg
- J1303 — Injection, ravulizumab-cwvz, 10 mg
- J1304 — Injection, tofersen, 1 mg
- J1305 — Injection, evinacumab-dgnb, 5mg
- J1306 — Injection, inclisiran, 1 mg
- J1307 — Injection, crovalimab-akkz, 10 mg
- J1308 — Injection, famotidine, 0.25 mg
- J1320 — Injection, amitriptyline hcl, up to 20 mg
- J1322 — Injection, elosulfase alfa, 1 mg
- J1323 — Injection, elranatamab-bcmm, 1 mg
- J1324 — Injection, enfuvirtide, 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 J1302
- Watch J1302 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J1302
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.