J1434 HCPCS code: Injection, fosaprepitant (focinvez), 1 mg
J1434 is the HCPCS Level II code for injection, fosaprepitant (focinvez), 1 mg. In 2024 Medicare paid an average of $2.37 per service for J1434 across 1,130,029 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 150 per day on DME suppliers. In 2024, about 333 clinicians billed Medicare for J1434 for 2,182 beneficiaries; Florida, Nebraska, Arkansas accounted for 94% of services.
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 | 2024-04-01 |
| Last action effective | 2024-04-01 |
Who bills J1434 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 333 |
| Medicare beneficiaries | 2,182 |
| States with claims | 7 |
| Share of services in top 3 states (Florida, Nebraska, Arkansas) | 94% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J1434, 2024–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2024 | 1,130,029 | 2,182 | $2.97 | $2.37 |
States with the most J1434 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 944,251 | $2.27 |
| Nebraska | 60,900 | $2.42 |
| Arkansas | 42,654 | $2.65 |
| Illinois | 24,450 | $2.41 |
| Oklahoma | 22,070 | $4.74 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 150 | Prescribing Information |
| outpatient hospital claims | 150 | Prescribing Information |
| practitioner claims | 150 | Prescribing Information |
What changed for J1434
- 2024-04-01: J1434 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 J1434?
J1434 is the HCPCS Level II code for injection, fosaprepitant (focinvez), 1 mg. Short descriptor: "Inj, focinvez, 1mg".
How much does Medicare pay for J1434?
In 2024, the average Medicare payment was $2.37 per service (average allowed $2.97).
Does Medicare cover J1434?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J1434 can be billed per day?
150 on DME suppliers; 150 on outpatient hospital claims; 150 on practitioner claims (NCCI medically unlikely edits).
Related J14 codes
- J1410 — Injection, estrogen conjugated, per 25 mg
- J1411 — Injection, etranacogene dezaparvovec-drlb, per therapeutic dose
- J1412 — Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes
- J1413 — Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose
- J1414 — Injection, fidanacogene elaparvovec-dzkt, per therapeutic dose
- J1426 — Injection, casimersen, 10 mg
- J1427 — Injection, viltolarsen, 10 mg
- J1428 — Injection, eteplirsen, 10 mg
- J1429 — Injection, golodirsen, 10 mg
- J1430 — Injection, ethanolamine oleate, 100 mg
- J1435 — Injection, estrone, per 1 mg
- J1436 — Injection, etidronate disodium, per 300 mg
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Next steps
- Run a reimbursement report for a device billed under J1434
- Watch J1434 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J1434
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.