J3590 HCPCS code: Unclassified biologics
J3590 is the HCPCS Level II code for unclassified biologics. In 2024 Medicare paid an average of $354.51 per service for J3590 across 253,780 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. Medicare volume fell 40% from 2022 to 2024 (424,689 to 253,780 services). In 2024, about 2,409 clinicians billed Medicare for J3590 for 43,565 beneficiaries; Washington, Ohio, Florida accounted for 39% of services.
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 | 2003-01-01 |
| Last action effective | 2003-01-01 |
Who bills J3590 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 2,409 |
| Medicare beneficiaries | 43,565 |
| States with claims | 49 |
| Share of services in top 3 states (Washington, Ohio, Florida) | 39% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J3590, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 424,689 | 50,975 | $354.65 | $282.17 |
| 2023 | 236,032 | 37,371 | $278.16 | $220.70 |
| 2024 | 253,780 | 43,565 | $446.82 | $354.51 |
States with the most J3590 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Washington | 41,915 | $11.07 |
| Ohio | 31,037 | $251.20 |
| Florida | 25,763 | $130.42 |
| Michigan | 16,957 | $127.24 |
| Indiana | 14,926 | $75.62 |
Medicare policy articles for this code
- A52370: Billing and Coding: Bevacizumab and biosimilars (Wellpoint Federal (MAC - Part A, MAC - Part B))
- A52451: Billing and Coding: Ranibizumab, Aflibercept and biosimilars (Wellpoint Federal (MAC - Part A, MAC - Part B))
- A54880: Billing and Coding: Additional Claim Documentation Requirements for Not Otherwise Classified (NOC) Drugs and Biological Products with Specific FDA Label Indications (Palmetto GBA (MAC - Part A, MAC - Part B))
- A55913: Billing and Coding: Hospital Outpatient Drugs and Biologicals Under the Outpatient Prospective Payment System (OPPS) (Palmetto GBA (MAC - Part A))
- A56380: Billing and Coding: Rituximab (Palmetto GBA (MAC - Part A, MAC - Part B))
Covered diagnoses (1,189 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| C83.30 | Diffuse large B-cell lymphoma, unspecified site | 2 |
| C83.31 | Diffuse large B-cell lymphoma, lymph nodes of head, face, and neck | 2 |
| C83.390 | Primary central nervous system lymphoma | 2 |
| C83.398 | Diffuse large B-cell lymphoma of other extranodal and solid organ sites | 2 |
| C83.3A | Diffuse large B-cell lymphoma, in remission | 2 |
| C83.59 | Lymphoblastic (diffuse) lymphoma, extranodal and solid organ sites | 2 |
| C83.79 | Burkitt lymphoma, extranodal and solid organ sites | 2 |
| C83.80 | Other non-follicular lymphoma, unspecified site | 2 |
| C83.81 | Other non-follicular lymphoma, lymph nodes of head, face, and neck | 2 |
| C83.89 | Other non-follicular lymphoma, extranodal and solid organ sites | 2 |
Showing 10 of 1,189. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for J3590
- 2003-01-01: J3590 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 J3590?
J3590 is the HCPCS Level II code for unclassified biologics. Short descriptor: "Unclassified biologics".
How much does Medicare pay for J3590?
In 2024, the average Medicare payment was $354.51 per service (average allowed $446.82).
Does Medicare cover J3590?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for J3590?
Medicare policy articles that cite J3590 list 1,189 covered ICD-10-CM diagnosis codes across 5 articles. The most cited include C83.30 (Diffuse large B-cell lymphoma, unspecified site), C83.31 (Diffuse large B-cell lymphoma, lymph nodes of head, face, and neck), C83.390 (Primary central nervous system lymphoma). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
Related J35 codes
- J3520 — Edetate disodium, per 150 mg
- J3530 — Nasal vaccine inhalation
- J3535 — Drug administered through a metered dose inhaler
- J3570 — Laetrile, amygdalin, vitamin b17
- J3591 — Unclassified drug or biological used for esrd on dialysis
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 J3590
- Watch J3590 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J3590
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.