J2679 HCPCS code: Injection, fluphenazine hcl, 1.25 mg
J2679 is the HCPCS Level II code for injection, fluphenazine hcl, 1.25 mg. 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 8 per day on outpatient hospital claims.
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 | 2024-01-01 |
| Last action effective | 2025-01-01 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 8 | Prescribing Information |
| practitioner claims | 8 | Prescribing Information |
What changed for J2679
- 2024-01-01: J2679 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 J2679?
J2679 is the HCPCS Level II code for injection, fluphenazine hcl, 1.25 mg. Short descriptor: "Inj fluphenazine hcl 1.25 mg".
Does Medicare cover J2679?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of J2679 can be billed per day?
8 on outpatient hospital claims; 8 on practitioner claims (NCCI medically unlikely edits).
Related J26 codes
- J2601 — Injection, vasopressin (baxter), 1 unit
- J2650 — Injection, prednisolone acetate, up to 1 ml
- J2670 — Injection, tolazoline hcl, up to 25 mg
- J2675 — Injection, progesterone, per 50 mg
- J2680 — Injection, fluphenazine decanoate, up to 25 mg
- J2690 — Injection, procainamide hcl, up to 1 gm
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Next steps
- Run a reimbursement report for a device billed under J2679
- Watch J2679 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J2679
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.