J1920 HCPCS code: Injection, labetalol hydrochloride, 5 mg
J1920 is the HCPCS Level II code for injection, labetalol hydrochloride, 5 mg. In 2024 Medicare paid an average of $0.16 per service for J1920 across 1,770 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. Medicare volume rose 266% from 2023 to 2024 (483 to 1,770 services). In 2024, about 123 clinicians billed Medicare for J1920 for 411 beneficiaries; California, Colorado, Florida accounted for 57% 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 | 2023-07-01 |
| Last action effective | 2024-01-01 |
Who bills J1920 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 123 |
| Medicare beneficiaries | 411 |
| States with claims | 11 |
| Share of services in top 3 states (California, Colorado, Florida) | 57% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J1920, 2023–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2023 | 483 | 69 | $0.20 | $0.16 |
| 2024 | 1,770 | 411 | $0.20 | $0.16 |
States with the most J1920 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 322 | $0.15 |
| Colorado | 238 | $0.14 |
| Florida | 176 | $0.16 |
| North Carolina | 130 | $0.18 |
| Texas | 121 | $0.15 |
What changed for J1920
- 2023-07-01: J1920 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 J1920?
J1920 is the HCPCS Level II code for injection, labetalol hydrochloride, 5 mg. Short descriptor: "Inj, labetalol hcl, 5mg".
How much does Medicare pay for J1920?
In 2024, the average Medicare payment was $0.16 per service (average allowed $0.20).
Does Medicare cover J1920?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Related J19 codes
- J1921 — Injection, labetalol hydrochloride (hikma), not therapeutically equivalent to j1920, 5 mg
- J1930 — Injection, lanreotide, 1 mg
- J1931 — Injection, laronidase, 0.1 mg
- J1932 — Injection, lanreotide, (cipla), 1 mg
- J1938 — Injection, furosemide, 1 mg
- J1939 — Injection, bumetanide, 0.5 mg
- J1940 — Injection, furosemide, up to 20 mg
- J1941 — Injection, furosemide (furoscix), 20 mg
- J1942 — Injection, aripiprazole lauroxil, 1 mg
- J1943 — Injection, aripiprazole lauroxil, (aristada initio), 1 mg
- J1944 — Injection, aripiprazole lauroxil, (aristada), 1 mg
- J1945 — Injection, lepirudin, 50 mg
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Next steps
- Run a reimbursement report for a device billed under J1920
- Watch J1920 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J1920
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.