J7799 HCPCS code: Noc drugs, other than inhalation drugs, administered through dme
J7799 is the HCPCS Level II code for noc drugs, other than inhalation drugs, administered through dme. In 2024 Medicare paid an average of $368.17 per service for J7799 across 304 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 2 per day on outpatient hospital claims. Medicare volume fell 83% from 2022 to 2024 (1,777 to 304 services). In 2024, about 36 clinicians billed Medicare for J7799 for 137 beneficiaries.
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 | D1G — Drugs administered through DME |
| Added | 1993-01-01 |
| Last action effective | 2002-07-01 |
Who bills J7799 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 36 |
| Medicare beneficiaries | 137 |
| States with claims | 2 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J7799, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 1,777 | 189 | $153.09 | $121.80 |
| 2023 | 495 | 121 | $472.37 | $375.83 |
| 2024 | 304 | 137 | $463.22 | $368.17 |
States with the most J7799 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Texas | 251 | $433.38 |
| Oklahoma | 34 | $36.89 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 2 | Clinical: CMS Workgroup |
| practitioner claims | 2 | Clinical: CMS Workgroup |
What changed for J7799
- 1993-01-01: J7799 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 J7799?
J7799 is the HCPCS Level II code for noc drugs, other than inhalation drugs, administered through dme. Short descriptor: "Non-inhalation drug for dme".
How much does Medicare pay for J7799?
In 2024, the average Medicare payment was $368.17 per service (average allowed $463.22).
Does Medicare cover J7799?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of J7799 can be billed per day?
2 on outpatient hospital claims; 2 on practitioner claims (NCCI medically unlikely edits).
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 J7799
- Watch J7799 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J7799
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.