Injection, lenacapavir, 1 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)
Code effective Oct 01, 2025
HCPCS Section
Drugs administered other than oral method, chemotherapy drugs
J0738 is a valid 2026 HCPCS code meaning Injection, lenacapavir, 1 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv) or (Hiv prep, inj, lenacapavir) for short. HCPCS J0738 has been effective since 10/01/2025 and applies to Medical care.
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HCPCS Level II Code Section J - Drugs administered other than oral method, chemotherapy drugs |
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| HCPCS Code | J0738 |
|---|---|
| Description |
Long description:
Short description: |
| HCPCS Pricing indicator |
57 - Other carrier priced
|
| Multiple pricing indicator |
A - Not applicable as HCPCS priced under one methodology
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| Statute number | 1861 ddd |
| Coverage code | D - Special coverage instructions apply |
| ASC payment group code | Effective Oct 01, 2025 - 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 Oct 01, 2025 |
| Date added | Added Oct 01, 2025 |
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”
HCPCS Level II codes and descriptors are approved and maintained jointly by the alpha-numeric editorial panel (consisting of CMS, the Health Insurance Association of America, and the Blue Cross and Blue Shield Association). — Updated 6/23/2026
CPT® is a registered trademark of the American Medical Association (AMA). All rights reserved.