J3240 HCPCS code: Injection, thyrotropin alpha, 0.9 mg, provided in 1.1 mg vial
J3240 is the HCPCS Level II code for injection, thyrotropin alpha, 0.9 mg, provided in 1.1 mg vial. In 2024 Medicare paid an average of $1,484.26 per service for J3240 across 1,122 services. 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 1 per day on outpatient hospital claims. Medicare volume fell 24% from 2022 to 2024 (1,471 to 1,122 services). In 2024, about 399 clinicians billed Medicare for J3240 for 572 beneficiaries; California, Florida, Texas accounted for 45% of services.
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 | 1986-01-01 |
| Last action effective | 2003-01-01 |
Who bills J3240 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 399 |
| Medicare beneficiaries | 572 |
| States with claims | 17 |
| Share of services in top 3 states (California, Florida, Texas) | 45% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J3240, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 1,471 | 713 | $1,701.77 | $1,353.46 |
| 2023 | 1,260 | 622 | $1,838.62 | $1,459.50 |
| 2024 | 1,122 | 572 | $1,868.21 | $1,484.26 |
States with the most J3240 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 197 | $1,520.23 |
| Florida | 103 | $1,539.03 |
| Texas | 102 | $1,548.95 |
| North Carolina | 56 | $1,591.84 |
| Connecticut | 54 | $665.93 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 1 | Prescribing Information |
| practitioner claims | 1 | Prescribing Information |
What changed for J3240
- 1986-01-01: J3240 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 J3240?
J3240 is the HCPCS Level II code for injection, thyrotropin alpha, 0.9 mg, provided in 1.1 mg vial. Short descriptor: "Thyrotropin injection".
How much does Medicare pay for J3240?
In 2024, the average Medicare payment was $1,484.26 per service (average allowed $1,868.21).
Does Medicare cover J3240?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of J3240 can be billed per day?
1 on outpatient hospital claims; 1 on practitioner claims (NCCI medically unlikely edits).
Related J32 codes
- J3230 — Injection, chlorpromazine hcl, up to 50 mg
- J3241 — Injection, teprotumumab-trbw, 10 mg
- J3243 — Injection, tigecycline, 1 mg
- J3244 — Injection, tigecycline (accord), not therapeutically equivalent to j3243, 1 mg
- J3245 — Injection, tildrakizumab, 1 mg
- J3246 — Injection, tirofiban hcl, 0.25 mg
- J3247 — Injection, secukinumab, intravenous, 1 mg
- J3250 — Injection, trimethobenzamide hcl, up to 200 mg
- J3260 — Injection, tobramycin sulfate, up to 80 mg
- J3262 — Injection, tocilizumab, 1 mg
- J3263 — Injection, toripalimab-tpzi, 1 mg
- J3265 — Injection, torsemide, 10 mg/ml
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Next steps
- Run a reimbursement report for a device billed under J3240
- Watch J3240 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J3240
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.