J1326 HCPCS code: Injection, zolbetuximab-clzb, 2 mg
J1326 is the HCPCS Level II code for injection, zolbetuximab-clzb, 2 mg. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 1200 per day on outpatient hospital claims.
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 | O1D — Chemotherapy |
| Added | 2025-07-01 |
| Last action effective | 2025-07-01 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 1200 | Prescribing Information |
| practitioner claims | 1200 | Prescribing Information |
What changed for J1326
- July 2025: Code appears in this HCPCS release
- 2025-07-01: J1326 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 J1326?
J1326 is the HCPCS Level II code for injection, zolbetuximab-clzb, 2 mg. Short descriptor: "Inj, zolbetuximab-clzb, 2 mg".
Does Medicare cover J1326?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J1326 can be billed per day?
1200 on outpatient hospital claims; 1200 on practitioner claims (NCCI medically unlikely edits).
Related J13 codes
- J1300 — Injection, eculizumab, 10 mg
- J1301 — Injection, edaravone, 1 mg
- J1302 — Injection, sutimlimab-jome, 10 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
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Next steps
- Run a reimbursement report for a device billed under J1326
- Watch J1326 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J1326
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.