J1602 HCPCS code: Injection, golimumab, 1 mg, for intravenous use
J1602 is the HCPCS Level II code for injection, golimumab, 1 mg, for intravenous use. In 2024 Medicare paid an average of $8.99 per service for J1602 across 23,986,169 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 300 per day on outpatient hospital claims. Medicare volume rose 14% from 2022 to 2024 (20,960,842 to 23,986,169 services). In 2024, about 3,670 clinicians billed Medicare for J1602 for 28,225 beneficiaries; Texas, Florida, California accounted for 23% 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 | 2014-01-01 |
| Last action effective | 2014-01-01 |
Who bills J1602 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 3,670 |
| Medicare beneficiaries | 28,225 |
| States with claims | 51 |
| Share of services in top 3 states (Texas, Florida, California) | 23% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J1602, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 20,960,842 | 25,084 | $14.63 | $11.63 |
| 2023 | 22,912,221 | 27,391 | $13.11 | $10.40 |
| 2024 | 23,986,169 | 28,225 | $11.35 | $8.99 |
States with the most J1602 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Texas | 2,079,694 | $8.96 |
| Florida | 2,010,050 | $9.03 |
| California | 1,451,486 | $9.04 |
| North Carolina | 1,409,252 | $9.00 |
| South Carolina | 1,203,198 | $8.94 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 300 | Prescribing Information |
| practitioner claims | 300 | Prescribing Information |
What changed for J1602
- 2014-01-01: J1602 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 J1602?
J1602 is the HCPCS Level II code for injection, golimumab, 1 mg, for intravenous use. Short descriptor: "Golimumab for iv use 1mg".
How much does Medicare pay for J1602?
In 2024, the average Medicare payment was $8.99 per service (average allowed $11.35).
Does Medicare cover J1602?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J1602 can be billed per day?
300 on outpatient hospital claims; 300 on practitioner claims (NCCI medically unlikely edits).
Related J16 codes
- J1600 — Injection, gold sodium thiomalate, up to 50 mg
- J1610 — Injection, glucagon hydrochloride, per 1 mg
- J1611 — Injection, glucagon hydrochloride (fresenius kabi), not therapeutically equivalent to j1610, per 1 mg
- J1612 — Injection, glucagon (gvoke), 0.01 mg
- J1620 — Injection, gonadorelin hydrochloride, per 100 mcg
- J1626 — Injection, granisetron hydrochloride, 100 mcg
- J1627 — Injection, granisetron, extended-release, 0.1 mg
- J1628 — Injection, guselkumab, 1 mg
- J1630 — Injection, haloperidol, up to 5 mg
- J1631 — Injection, haloperidol decanoate, per 50 mg
- J1632 — Injection, brexanolone, 1 mg
- J1640 — Injection, hemin, 1 mg
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Next steps
- Run a reimbursement report for a device billed under J1602
- Watch J1602 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J1602
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.