J3095 HCPCS code: Injection, telavancin, 10 mg
J3095 is the HCPCS Level II code for injection, telavancin, 10 mg. In 2024 Medicare paid an average of $5.45 per service for J3095 across 131,370 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 150 per day on outpatient hospital claims. Medicare volume fell 14% from 2022 to 2024 (153,197 to 131,370 services). In 2024, about 47 clinicians billed Medicare for J3095 for 117 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 | 2011-01-01 |
| Last action effective | 2011-01-01 |
Who bills J3095 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 47 |
| Medicare beneficiaries | 117 |
| States with claims | 2 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J3095, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 153,197 | 130 | $6.48 | $5.16 |
| 2023 | 209,129 | 142 | $6.87 | $5.47 |
| 2024 | 131,370 | 117 | $6.84 | $5.45 |
States with the most J3095 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 65,133 | $5.49 |
| Texas | 32,005 | $5.40 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 150 | Prescribing Information |
| practitioner claims | 150 | Prescribing Information |
What changed for J3095
- 2011-01-01: J3095 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 J3095?
J3095 is the HCPCS Level II code for injection, telavancin, 10 mg. Short descriptor: "Telavancin injection".
How much does Medicare pay for J3095?
In 2024, the average Medicare payment was $5.45 per service (average allowed $6.84).
Does Medicare cover J3095?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J3095 can be billed per day?
150 on outpatient hospital claims; 150 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
- J3055 — Injection, talquetamab-tgvs, 0.25 mg
- J3060 — Injection, taliglucerase alfa, 10 units
- J3070 — Injection, pentazocine, 30 mg
- J3090 — Injection, tedizolid phosphate, 1 mg
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Next steps
- Run a reimbursement report for a device billed under J3095
- Watch J3095 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J3095
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.