J2246 HCPCS code: Injection, micafungin in sodium (baxter), not therapeutically equivalent to j2248, 1 mg
J2246 is the HCPCS Level II code for injection, micafungin in sodium (baxter), not therapeutically equivalent to j2248, 1 mg. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 150 per day on DME suppliers.
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 | 2024-07-01 |
| Last action effective | 2024-07-01 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 150 | Prescribing Information |
| outpatient hospital claims | 150 | Prescribing Information |
| practitioner claims | 150 | Prescribing Information |
What changed for J2246
- 2024-07-01: J2246 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 J2246?
J2246 is the HCPCS Level II code for injection, micafungin in sodium (baxter), not therapeutically equivalent to j2248, 1 mg. Short descriptor: "Inj, micafungin (baxter)".
Does Medicare cover J2246?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J2246 can be billed per day?
150 on DME suppliers; 150 on outpatient hospital claims; 150 on practitioner claims (NCCI medically unlikely edits).
Related J22 codes
- J2210 — Injection, methylergonovine maleate, up to 0.2 mg
- J2212 — Injection, methylnaltrexone, 0.1 mg
- J2247 — Injection, micafungin sodium (par pharm) not thereapeutically equivalent to j2248, 1 mg
- J2248 — Injection, micafungin sodium, 1 mg
- J2249 — Injection, remimazolam, 1 mg
- J2250 — Injection, midazolam hydrochloride, per 1 mg
- J2251 — Injection, midazolam in 0.9% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg
- J2252 — Injection, midazolam in 0.8% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg
- J2253 — Injection, midazolam (seizalam), 1 mg
- J2260 — Injection, milrinone lactate, 5 mg
- J2265 — Injection, minocycline hydrochloride, 1 mg
- J2267 — Injection, mirikizumab-mrkz, 1 mg
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Next steps
- Run a reimbursement report for a device billed under J2246
- Watch J2246 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J2246
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.