HCPCS Code Details - J0801

HCPCS Level II Code
Drugs administered other than oral method, chemotherapy drugs
HCPCS Code J0801
Description

Long description:
Injection, corticotropin (acthar gel), up to 40 units

Short description:
Inj. acthar gel to 40 units

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 Oct 01, 2023 - 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, 2023
Date added Added Oct 01, 2023
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 - J0801

Effective Code Dosage Payment
Limit
Vaccine AWP % Vaccine Limit Infusion AWP % DME infusion limit Blood AWP % Blood limit Clotting factor Note
October 1, 2024 - December 31, 2024 40 UNITS 3750.08 - - - - - -
Jul 1, 2024 - Sep 30, 2024 40 UNITS 3479.526 - - - - - -
April 1, 2024 - June 30, 2024 40 UNITS 3370.387 - - - - - -
January 1, 2024 - March 31, 2024 40 UNITS 4095.318 - - - - - -
October 1, 2023 - December 31, 2023 40 UNITS 4090.086 20% - - - - -

See also

  • HCPCS J0800 · Injection, corticotropin, up to 40 units

  • HCPCS J0802 · Injection, corticotropin (ani), up to 40 units


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”