J1442 HCPCS code: Injection, filgrastim (g-csf), excludes biosimilars, 1 microgram
J1442 is the HCPCS Level II code for injection, filgrastim (g-csf), excludes biosimilars, 1 microgram. In 2024 Medicare paid an average of $0.77 per service for J1442 across 3,963,781 services. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. The NCCI unit limit is 1500 per day on outpatient hospital claims. Medicare volume fell 23% from 2022 to 2024 (5,169,440 to 3,963,781 services). In 2024, about 968 clinicians billed Medicare for J1442 for 1,552 beneficiaries; Florida, California, Tennessee accounted for 53% 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 | 2014-01-01 |
| Last action effective | 2016-01-01 |
Who bills J1442 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 968 |
| Medicare beneficiaries | 1,552 |
| States with claims | 22 |
| Share of services in top 3 states (Florida, California, Tennessee) | 53% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J1442, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 5,169,440 | 1,859 | $0.98 | $0.78 |
| 2023 | 4,572,621 | 1,797 | $0.96 | $0.76 |
| 2024 | 3,963,781 | 1,552 | $0.97 | $0.77 |
States with the most J1442 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 1,303,097 | $0.77 |
| California | 371,449 | $0.77 |
| Tennessee | 339,540 | $0.77 |
| Georgia | 321,300 | $0.75 |
| New York | 236,885 | $0.76 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 1500 | Clinical: CMS Workgroup |
| practitioner claims | 1500 | Clinical: CMS Workgroup |
Medicare policy articles for this code
- A56748: Billing and Coding: White Cell Colony Stimulating Factors (Palmetto GBA (MAC - Part A, MAC - Part B))
Covered diagnoses (1,265 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| B20 | Human immunodeficiency virus [HIV] disease | 1 |
| C00.0 | Malignant neoplasm of external upper lip | 1 |
| C00.1 | Malignant neoplasm of external lower lip | 1 |
| C00.2 | Malignant neoplasm of external lip, unspecified | 1 |
| C00.3 | Malignant neoplasm of upper lip, inner aspect | 1 |
| C00.4 | Malignant neoplasm of lower lip, inner aspect | 1 |
| C00.5 | Malignant neoplasm of lip, unspecified, inner aspect | 1 |
| C00.6 | Malignant neoplasm of commissure of lip, unspecified | 1 |
| C00.8 | Malignant neoplasm of overlapping sites of lip | 1 |
| C00.9 | Malignant neoplasm of lip, unspecified | 1 |
Showing 10 of 1,265. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for J1442
- 2014-01-01: J1442 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 J1442?
J1442 is the HCPCS Level II code for injection, filgrastim (g-csf), excludes biosimilars, 1 microgram. Short descriptor: "Inj filgrastim excl biosimil".
How much does Medicare pay for J1442?
In 2024, the average Medicare payment was $0.77 per service (average allowed $0.97).
Does Medicare cover J1442?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Which diagnoses support coverage for J1442?
Medicare policy articles that cite J1442 list 1,265 covered ICD-10-CM diagnosis codes across 1 article. The most cited include B20 (Human immunodeficiency virus [HIV] disease), C00.0 (Malignant neoplasm of external upper lip), C00.1 (Malignant neoplasm of external lower lip). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
How many units of J1442 can be billed per day?
1500 on outpatient hospital claims; 1500 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
- J1434 — Injection, fosaprepitant (focinvez), 1 mg
- J1435 — Injection, estrone, per 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 J1442
- Watch J1442 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J1442
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.