J1746 HCPCS code: Injection, ibalizumab-uiyk, 10 mg
J1746 is the HCPCS Level II code for injection, ibalizumab-uiyk, 10 mg. In 2023 Medicare paid an average of $54.52 per service for J1746 across 12,166 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 200 per day on outpatient hospital claims. Medicare volume fell 23% from 2022 to 2023 (15,742 to 12,166 services). In 2023, about 20 clinicians billed Medicare for J1746 for 15 beneficiaries.
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 | 2019-01-01 |
| Last action effective | 2019-01-01 |
Who bills J1746 (2023)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 20 |
| Medicare beneficiaries | 15 |
| States with claims | 0 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J1746, 2022–2023
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 15,742 | 12 | $64.84 | $51.67 |
| 2023 | 12,166 | 15 | $68.46 | $54.52 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 200 | Prescribing Information |
| practitioner claims | 200 | Prescribing Information |
What changed for J1746
- 2019-01-01: J1746 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 J1746?
J1746 is the HCPCS Level II code for injection, ibalizumab-uiyk, 10 mg. Short descriptor: "Inj., ibalizumab-uiyk, 10 mg".
How much does Medicare pay for J1746?
In 2023, the average Medicare payment was $54.52 per service (average allowed $68.46).
Does Medicare cover J1746?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J1746 can be billed per day?
200 on outpatient hospital claims; 200 on practitioner claims (NCCI medically unlikely edits).
Related J17 codes
- J1700 — Injection, hydrocortisone acetate, up to 25 mg
- J1710 — Injection, hydrocortisone sodium phosphate, up to 50 mg
- J1720 — Injection, hydrocortisone sodium succinate, up to 100 mg
- J1725 — Injection, hydroxyprogesterone caproate, 1 mg
- J1726 — Injection, hydroxyprogesterone caproate, (makena), 10 mg
- J1729 — Injection, hydroxyprogesterone caproate, not otherwise specified, 10 mg
- J1730 — Injection, diazoxide, up to 300 mg
- J1736 — Injection, meloxicam (delova), 1 mg
- J1737 — Injection, meloxicam (azurity), 1 mg
- J1738 — Injection, meloxicam, 1 mg
- J1740 — Injection, ibandronate sodium, 1 mg
- J1741 — Injection, ibuprofen, 100 mg
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Next steps
- Run a reimbursement report for a device billed under J1746
- Watch J1746 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J1746
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.