J2326 HCPCS code: Injection, nusinersen, 0.1 mg
J2326 is the HCPCS Level II code for injection, nusinersen, 0.1 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 120 per day on outpatient hospital claims.
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 | 2018-01-01 |
| Last action effective | 2018-01-01 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 120 | Prescribing Information |
| practitioner claims | 120 | Prescribing Information |
What changed for J2326
- 2018-01-01: J2326 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 J2326?
J2326 is the HCPCS Level II code for injection, nusinersen, 0.1 mg. Short descriptor: "Inj, nusinersen, 0.1mg".
Does Medicare cover J2326?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J2326 can be billed per day?
120 on outpatient hospital claims; 120 on practitioner claims (NCCI medically unlikely edits).
Related J23 codes
- J2300 — Injection, nalbuphine hydrochloride, per 10 mg
- J2305 — Injection, nitroglycerin, 5 mg
- J2310 — Injection, naloxone hydrochloride, per 1 mg
- J2311 — Injection, naloxone hydrochloride (zimhi), 1 mg
- J2312 — Injection, naloxone hydrochloride, not otherwise specified, 0.01 mg
- J2313 — Injection, naloxone hydrochloride (zimhi), 0.01 mg
- J2315 — Injection, naltrexone, depot form, 1 mg
- J2320 — Injection, nandrolone decanoate, up to 50 mg
- J2323 — Injection, natalizumab, 1 mg
- J2325 — Injection, nesiritide, 0.1 mg
- J2327 — Injection, risankizumab-rzaa, intravenous, 1 mg
- J2329 — Injection, ublituximab-xiiy, 1mg
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Next steps
- Run a reimbursement report for a device billed under J2326
- Watch J2326 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J2326
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.