J3055 HCPCS code: Injection, talquetamab-tgvs, 0.25 mg
J3055 is the HCPCS Level II code for injection, talquetamab-tgvs, 0.25 mg. In 2024 Medicare paid an average of $52.45 per service for J3055 across 185,137 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 480 per day on DME suppliers. In 2024, about 245 clinicians billed Medicare for J3055 for 122 beneficiaries.
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 | 2024-04-01 |
| Last action effective | 2024-04-01 |
Who bills J3055 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 245 |
| Medicare beneficiaries | 122 |
| States with claims | 4 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J3055, 2024–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2024 | 185,137 | 122 | $65.83 | $52.45 |
States with the most J3055 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Tennessee | 20,856 | $53.05 |
| Minnesota | 20,676 | $50.68 |
| California | 19,645 | $53.04 |
| Florida | 14,377 | $53.04 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 480 | Prescribing Information |
| outpatient hospital claims | 480 | Prescribing Information |
| practitioner claims | 480 | Prescribing Information |
What changed for J3055
- 2024-04-01: J3055 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 J3055?
J3055 is the HCPCS Level II code for injection, talquetamab-tgvs, 0.25 mg. Short descriptor: "Inj talquetamab-tgvs 0.25 mg".
How much does Medicare pay for J3055?
In 2024, the average Medicare payment was $52.45 per service (average allowed $65.83).
Does Medicare cover J3055?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J3055 can be billed per day?
480 on DME suppliers; 480 on outpatient hospital claims; 480 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)
- J3031 — 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)
- J3032 — Injection, eptinezumab-jjmr, 1 mg
- J3060 — Injection, taliglucerase alfa, 10 units
- J3070 — Injection, pentazocine, 30 mg
- J3090 — Injection, tedizolid phosphate, 1 mg
- J3095 — Injection, telavancin, 10 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 J3055
- Watch J3055 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J3055
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.