J2251 HCPCS code: Injection, midazolam in 0.9% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg
J2251 is the HCPCS Level II code for injection, midazolam in 0.9% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg. In 2023 Medicare paid an average of $0.24 per service for J2251 across 37 services. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. The NCCI unit limit is 22 per day on outpatient hospital claims. In 2023, about 3 clinicians billed Medicare for J2251 for 17 beneficiaries.
Code details
| Field | Value |
|---|---|
| Section | J codes — Drugs administered other than oral method |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 51 — Drug or biological (priced per ASP/average sales price rules) |
| BETOS category | O1E — Other drugs |
| Added | 2023-01-01 |
| Last action effective | 2024-10-01 |
Who bills J2251 (2023)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 3 |
| Medicare beneficiaries | 17 |
| States with claims | 0 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J2251, 2023–2023
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2023 | 37 | 17 | $0.30 | $0.24 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 22 | Prescribing Information |
| practitioner claims | 22 | Prescribing Information |
What changed for J2251
- 2023-01-01: J2251 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 J2251?
J2251 is the HCPCS Level II code for injection, midazolam in 0.9% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg. Short descriptor: "Inj midazolam in 0.9% nacl".
How much does Medicare pay for J2251?
In 2023, the average Medicare payment was $0.24 per service (average allowed $0.30).
Does Medicare cover J2251?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of J2251 can be billed per day?
22 on outpatient hospital claims; 22 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
- J2246 — Injection, micafungin in sodium (baxter), not therapeutically equivalent to j2248, 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
- 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
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under J2251
- Watch J2251 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J2251
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.