J1573 HCPCS code: Injection, hepatitis b immune globulin (hepagam b), intravenous, 0.5 ml
J1573 is the HCPCS Level II code for injection, hepatitis b immune globulin (hepagam b), intravenous, 0.5 ml. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 130 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 | O1E — Other drugs |
| Added | 2008-01-01 |
| Last action effective | 2009-01-01 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 130 | Prescribing Information |
| practitioner claims | 130 | Prescribing Information |
Medicare policy articles for this code
- A57554: Billing and Coding: Immune Globulins (WPS Insurance Corporation (MAC - Part A, MAC - Part B))
Covered diagnoses (1,176 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| B16.1 | Acute hepatitis B with delta-agent without hepatic coma | 1 |
| B16.2 | Acute hepatitis B without delta-agent with hepatic coma | 1 |
| B16.9 | Acute hepatitis B without delta-agent and without hepatic coma | 1 |
| B17.0 | Acute delta-(super) infection of hepatitis B carrier | 1 |
| B18.0 | Chronic viral hepatitis B with delta-agent | 1 |
| B18.1 | Chronic viral hepatitis B without delta-agent | 1 |
| B19.10 | Unspecified viral hepatitis B without hepatic coma | 1 |
| B19.11 | Unspecified viral hepatitis B with hepatic coma | 1 |
| B20 | Human immunodeficiency virus [HIV] disease | 1 |
| C88.20 | Heavy chain disease not having achieved remission | 1 |
Showing 10 of 1,176. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for J1573
- 2008-01-01: J1573 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 J1573?
J1573 is the HCPCS Level II code for injection, hepatitis b immune globulin (hepagam b), intravenous, 0.5 ml. Short descriptor: "Hepagam b intravenous, inj".
Does Medicare cover J1573?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for J1573?
Medicare policy articles that cite J1573 list 1,176 covered ICD-10-CM diagnosis codes across 1 article. The most cited include B16.1 (Acute hepatitis B with delta-agent without hepatic coma), B16.2 (Acute hepatitis B without delta-agent with hepatic coma), B16.9 (Acute hepatitis B without delta-agent and without hepatic coma). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
How many units of J1573 can be billed per day?
130 on outpatient hospital claims; 130 on practitioner claims (NCCI medically unlikely edits).
Related J15 codes
- J1551 — Injection, immune globulin (cutaquig), 100 mg
- J1552 — Injection, immune globulin (alyglo), 500 mg
- J1554 — Injection, immune globulin (asceniv), 500 mg
- J1555 — Injection, immune globulin (cuvitru), 100 mg
- J1556 — Injection, immune globulin (bivigam), 500 mg
- J1557 — Injection, immune globulin, (gammaplex), intravenous, non-lyophilized (e.g., liquid), 500 mg
- J1558 — Injection, immune globulin (xembify), 100 mg
- J1559 — Injection, immune globulin (hizentra), 100 mg
- J1560 — Injection, gamma globulin, intramuscular, over 10 cc
- J1561 — Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg
- J1562 — Injection, immune globulin (vivaglobin), 100 mg
- J1566 — Injection, immune globulin, intravenous, lyophilized (e.g., powder), not otherwise specified, 500 mg
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Next steps
- Run a reimbursement report for a device billed under J1573
- Watch J1573 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J1573
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.