HCPCS Code Details - J0695

HCPCS Level II Code
Drugs administered other than oral method, chemotherapy drugs
HCPCS Code J0695
Description

Long description:
Injection, ceftolozane 50 mg and tazobactam 25 mg

Short description:
Inj ceftolozane tazobactam

HCPCS Modifier1
HCPCS Pricing indicator 51 - Drugs
Multiple pricing indicator A - Not applicable as HCPCS priced under one methodology
Coverage code C - Carrier judgment
ASC payment group code Effective Jan 01, 2016 - This procedure is approved to be performed in an ambulatory surgical center.
BETOS2 code O1E - Other drugs
HCPCS Action code N - No maintenance for this code
Type of service 1 - Medical care
Effective date Effective Jan 01, 2016
Date added Added Jan 01, 2016
HCPCS Coding Procedures

HCPCS Modifiers

In HCPCS Level II, modifiers are composed of two alpha or alphanumeric characters.

Example: E0260-NU - Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress
NU” identifies the hospital bed as new equipment

ASP Drug pricing - J0695

Effective Code Dosage Payment
Limit
Vaccine AWP % Vaccine Limit Infusion AWP % DME infusion limit Blood AWP % Blood limit Clotting factor Note
April 1, 2024 - June 30, 2024 75mg (50mg cft/25mg taz) 7.289 - - - - - -
January 1, 2024 - March 31, 2024 75mg (50mg cft/25mg taz) 7.37 - - - - - -
October 1, 2023 - December 31, 2023 75mg (50mg cft/25mg taz) 7.481 20% - - - - -
Jul 1, 2023 - Sep 30, 2023 75mg (50mg cft/25mg taz) 7.54 20% - - - - -
April 1, 2023 - June 30, 2023 75mg (50mg cft/25mg taz) 6.714 20% - - - - -

See also

  • HCPCS J0694 · Injection, cefoxitin sodium, 1 gm

  • HCPCS C9452 · Injection, ceftolozane 50 mg and tazobactam 25 mg

  • HCPCS J0696 · Injection, ceftriaxone sodium, per 250 mg


1 Two-digit numeric codes are Level I code modifiers copyrighted© by the American Medical Association's Current Procedural Terminology (CPT).

2 BETOS stands for “Berenson-Eggers Type Of Service”