J3031 HCPCS code: Injection, fremanezumab-vfrm, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self-administered)
J3031 is the HCPCS Level II code for injection, fremanezumab-vfrm, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self-administered). Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 675 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 | 2019-10-01 |
| Last action effective | 2019-10-01 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 675 | Prescribing Information |
| practitioner claims | 675 | Prescribing Information |
What changed for J3031
- 2019-10-01: J3031 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 J3031?
J3031 is the HCPCS Level II code for injection, fremanezumab-vfrm, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self-administered). Short descriptor: "Inj., fremanezumab-vfrm 1 mg".
Does Medicare cover J3031?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J3031 can be billed per day?
675 on outpatient hospital claims; 675 on practitioner claims (NCCI medically unlikely edits).
Related J30 codes
- J3000 — Injection, streptomycin, up to 1 gm
- J3010 — Injection, fentanyl citrate, 0.1 mg
- J3030 — Injection, sumatriptan succinate, 6 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)
- J3032 — Injection, eptinezumab-jjmr, 1 mg
- J3055 — Injection, talquetamab-tgvs, 0.25 mg
- J3060 — Injection, taliglucerase alfa, 10 units
- J3070 — Injection, pentazocine, 30 mg
- J3090 — Injection, tedizolid phosphate, 1 mg
- J3095 — Injection, telavancin, 10 mg
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Next steps
- Run a reimbursement report for a device billed under J3031
- Watch J3031 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J3031
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.