J3250 HCPCS code: Injection, trimethobenzamide hcl, up to 200 mg
J3250 is the HCPCS Level II code for injection, trimethobenzamide hcl, up to 200 mg. In 2024 Medicare paid an average of $30.91 per service for J3250 across 686 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 4 per day on outpatient hospital claims. Medicare volume fell 70% from 2022 to 2024 (2,308 to 686 services). In 2024, about 103 clinicians billed Medicare for J3250 for 343 beneficiaries; California, Illinois, Michigan accounted for 92% 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 | 1982-01-01 |
| Last action effective | 1997-01-01 |
Who bills J3250 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 103 |
| Medicare beneficiaries | 343 |
| States with claims | 6 |
| Share of services in top 3 states (California, Illinois, Michigan) | 92% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J3250, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 2,308 | 477 | $39.04 | $29.71 |
| 2023 | 1,491 | 438 | $39.24 | $29.86 |
| 2024 | 686 | 343 | $41.67 | $30.91 |
States with the most J3250 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 523 | $31.58 |
| Illinois | 59 | $28.87 |
| Michigan | 25 | $28.10 |
| New Jersey | 20 | $26.26 |
| Pennsylvania | 19 | $28.58 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 4 | Prescribing Information |
| practitioner claims | 2 | Prescribing Information |
What changed for J3250
- 1982-01-01: J3250 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 J3250?
J3250 is the HCPCS Level II code for injection, trimethobenzamide hcl, up to 200 mg. Short descriptor: "Trimethobenzamide hcl inj".
How much does Medicare pay for J3250?
In 2024, the average Medicare payment was $30.91 per service (average allowed $41.67).
Does Medicare cover J3250?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of J3250 can be billed per day?
4 on outpatient hospital claims; 2 on practitioner claims (NCCI medically unlikely edits).
Related J32 codes
- J3230 — Injection, chlorpromazine hcl, up to 50 mg
- J3240 — Injection, thyrotropin alpha, 0.9 mg, provided in 1.1 mg vial
- 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
- 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
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 J3250
- Watch J3250 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J3250
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.