HCPCS Code Applications and Approvals: January 2025
Quarterly archive · CMS Level II HCPCS55 coding decisions from the Third Quarter 2024 CMS cycle
These are the Centers for Medicare and Medicaid Services (CMS) Level II HCPCS drug coding decisions from the Third Quarter 2024 coding cycle, which took effect January 1, 2025.
For the newest decisions, see the current HCPCS code applications and approvals.
CMS Level II HCPCS Drug Coding Decisions
Does not include Q4 skin repair and wound codes.
How to Read This Table
- Action
- CMS decision on the application — establish a new code, revise an existing descriptor, reinstate a code, or discontinue one. See the glossary.
- Code Change
- Where CMS retires a code in favor of another, the new code shows the code it replaces and the retired code shows its replacement.
- 505(b)(2) and Biosimilar
- Tags beside the drug name mark products approved under the FDA 505(b)(2) pathway and biosimilars.
- Effective
- First date of service on which the code may be billed. Codes effective before this quarter reflect retroactive establishment; codes effective after it are decisions CMS scheduled for a later quarter.
January 2025
| HCPCS | Drug & Descriptor | Company | Code Change | Action | Effective |
|---|---|---|---|---|---|
| A9615 | LUMISIGHT Injection, pegulicianine, 1 mg | Lumicell, Inc. Intravenous | ReplacesC9171 | Establish | |
| C9169 | ANKTIVA Injection, nogapendekin alfa inbakicept-pmln, for intravesical use, 1 microgram | Immunity Bio, Inc. Intravesical | Replaced byJ9028 | Discontinue | |
| C9170 | IMDELLTRA Injection, tarlatamab-dlle, 1 mg | Amgen Intravenous | Replaced byJ9026 | Discontinue | |
| C9171 | LUMISIGHT Injection, pegulicianine, 1 mg | Lumicell, Inc. Intravenous | Replaced byA9615 | Discontinue | |
| C9172 | BEQVEZ Injection, fidanacogene elaparvovec-dzkt, per therapeutic dose | Pfizer, Inc. Intravenous | Replaced byJ1414 | Discontinue | |
| C9290 | EXPAREL 505(b)(2) Injection, bupivacaine liposome, 1 mg | Pacira BioSciences, Inc. | Replaced byJ0666 | Discontinue | |
| J0135 | Adalimumab Injection, adalimumab, 20 mg | — | Replaced byJ0139 | Discontinue | |
| J0139 | Adalimumab Injection, adalimumab, 1 mg | — | ReplacesJ0135 | Establish | |
| J0570 | PROBUPHINE Buprenorphine implant, 74.2 mg | — | — | Discontinue | |
| J0666 | EXPAREL 505(b)(2) Injection, bupivacaine liposome, 1 mg | Pacira BioSciences, Inc. | ReplacesC9290 | Establish | |
| J0870 | RYTELO Injection, imetelstat, 1 mg | Geron Corporation Intravenous | — | Establish | |
| J0901 | VAFSEO Vadadustat, oral, 1 mg (for esrd on dialysis) | Akebia Therapeutics, Inc. (Akebia) | — | Establish | |
| J1307 | PIASKY Injection, crovalimab-akkz, 10 mg | Genentech Intravenous | — | Establish | |
| J1414 | BEQVEZ Injection, fidanacogene elaparvovec-dzkt, per therapeutic dose | Pfizer, Inc. Intravenous | ReplacesC9172 | Establish | |
| J1552 | Immune Globulin (Alyglo) 505(b)(2) Injection, immune globulin (alyglo), 500 mg | — | — | Establish | |
| J2290 | Nafcillin Sodium 505(b)(2) Injection, nafcillin sodium, 20 mg | — | — | Establish | |
| J2468 | POSFREA 505(b)(2) Injection, palonosetron hydrochloride (posfrea), 25 micrograms | Avyxa Holdings, LLC | — | Revise | |
| J2472 | Pantoprazole Sodium in Sodium Chloride 505(b)(2) Injection, pantoprazole sodium in sodium chloride (baxter), 40 mg | — Intravenous | — | Establish | |
| J2796 | Romiplostim Injection, romiplostim, 10 micrograms | — | Replaced byJ2802 | Discontinue | |
| J2802 | Romiplostim Injection, romiplostim, 1 microgram | — | ReplacesJ2796 | Establish | |
| J2806 | Sincalide (Maia) Injection, sincalide (maia), not therapeutically equivalent to j2805, 5 micrograms | — | — | Discontinue | |
| J3392 | CASGEVY Injection, exagamglogene autotemcel, per treatment | Vertex Pharmaceuticals Incorporated Intravenous | — | Establish | |
| J7514 | MYHIBBIN 505(b)(2) Mycophenolate mofetil (myhibbin), oral suspension, 100 mg | Azurity Pharmaceuticals, Inc. Oral | — | Establish | |
| J7601 | OHTUVAYRE Ensifentrine, inhalation suspension, fda approved final product, non-compounded, administered through dme, unit dose form, 3 mg | Verona Pharma, Inc. | — | Establish | |
| J9026 | IMDELLTRA Injection, tarlatamab-dlle, 1 mg | Amgen Intravenous | ReplacesC9170 | Establish | |
| J9028 | ANKTIVA Injection, nogapendekin alfa inbakicept-pmln, for intravesical use, 1 microgram | Immunity Bio, Inc. Intravesical | ReplacesC9169 | Establish | |
| J9033 | Bendamustine Hydrochloride Injection, bendamustine hydrochloride, 1 mg | — | ReplacesJ9058ReplacesJ9059 | Revise | |
| J9058 | Bendamustine Hydrochloride (Apotex) Injection, bendamustine hydrochloride (apotex), 1 mg | — | Replaced byJ9033 | Discontinue | |
| J9059 | Bendamustine Hydrochloride (Baxter) Injection, bendamustine hydrochloride (baxter), 1 mg | — | Replaced byJ9033 | Discontinue | |
| J9072 | Cyclophosphamide 505(b)(2) Injection, cyclophosphamide (avyxa), 5 mg | Avyxa Holdings, LLC | — | Revise | |
| J9076 | Baxter's Cyclophosphamide Injection 505(b)(2) Injection, cyclophosphamide (baxter), 5 mg | Baxter Healthcare Corporation | — | Establish | |
| J9259 | Paclitaxel Protein-Bound Particles (American Regent) Injection, paclitaxel protein-bound particles (american regent) not therapeutically equivalent to j9264, 1 mg | — | — | Discontinue | |
| J9292 | Avyxa's Pemetrexed for Injection 505(b)(2) Injection, pemetrexed (avyxa), not therapeutically equivalent to j9305, 10 mg | Avyxa Holdings, LLC Intravenous | — | Establish | |
| Q0155 | Dronabinol (Syndros) 505(b)(2) Dronabinol (syndros), 0.1 mg, oral, fda approved prescription anti- emetic, for use as a complete therapeutic substitute for an iv anti- emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen | — | — | Establish | |
| Q4346 | Shelter DM Matrix Shelter dm matrix, per square centimeter | Sequence LifeScience Inc. | — | Establish | |
| Q4347 | Rampart DL Matrix Rampart dl matrix, per square centimeter | Sequence LifeScience Inc. | — | Establish | |
| Q4348 | Sentry SL Matrix Sentry sl matrix, per square centimeter | Sequence LifeScience Inc. | — | Establish | |
| Q4349 | Mantle DL Matrix Mantle dl matrix, per square centimeter | Sequence LifeScience Inc. | — | Establish | |
| Q4350 | Palisade DM Matrix Palisade dm matrix, per square centimeter | Sequence LifeScience Inc. | — | Establish | |
| Q4351 | Enclose TL Matrix Enclose tl matrix, per square centimeter | Sequence LifeScience Inc. | — | Establish | |
| Q4352 | Overlay SL Matrix Overlay sl matrix, per square centimeter | Sequence LifeScience | — | Establish | |
| Q4353 | Xceed TL Matrix Xceed tl matrix, per square centimeter | RMBB Health | — | Establish | |
| Q5131 | Adalimumab-Aacf (Idacio) Biosimilar Injection, adalimumab-aacf (idacio), biosimilar, 20 mg | — | Replaced byQ5144 | Discontinue | |
| Q5132 | Adalimumab-Afzb (Abrilada) Biosimilar Injection, adalimumab-afzb (abrilada), biosimilar, 10 mg | — | Replaced byQ5145 | Discontinue | |
| Q5139 | BKEMV Biosimilar Injection, eculizumab-aeeb (bkemv), biosimilar, 10 mg | Amgen Inc. Intravenous | — | Establish | |
| Q5140 | Adalimumab-Fkjp Biosimilar Injection, adalimumab-fkjp, biosimilar, 1 mg | — | — | Establish | |
| Q5141 | Adalimumab-Aaty Biosimilar Injection, adalimumab-aaty, biosimilar, 1 mg | — | — | Establish | |
| Q5142 | Adalimumab-Ryvk Biosimilar Biosimilar Injection, adalimumab-ryvk biosimilar, 1 mg | — | — | Establish | |
| Q5143 | Adalimumab-Adbm Biosimilar Injection, adalimumab-adbm, biosimilar, 1 mg | — | — | Establish | |
| Q5144 | Adalimumab-Aacf (Idacio) Biosimilar Injection, adalimumab-aacf (idacio), biosimilar, 1 mg | — | ReplacesQ5131 | Establish | |
| Q5145 | Adalimumab-Afzb (Abrilada) Biosimilar Injection, adalimumab-afzb (abrilada), biosimilar, 1 mg | — | ReplacesQ5132 | Establish | |
| Q5146 | Hercessi Biosimilar Injection, trastuzumab-strf (hercessi), biosimilar, 10 mg | Accord Biopharma Incorporated Intravenous | — | Establish | |
| Q9996 | PYZCHIVA Subcutaneous (SC) Injection, ustekinumab-ttwe (pyzchiva), subcutaneous, 1 mg | Sandoz Inc. | — | Establish | |
| Q9997 | PYZCHIVA Intravenous (IV) Injection, ustekinumab-ttwe (pyzchiva), intravenous, 1 mg | Sandoz Inc. Intravenous | — | Establish | |
| Q9998 | SELARSDI Subcutaneous (SC) Injection, ustekinumab-aekn (selarsdi), 1 mg | Teva Pharmaceuticals, Inc. | — | Establish |
No coding decisions match those filters.
Source: CMS HCPCS application summaries, Third Quarter 2024 coding cycle (PDF) . Data current as of October 7, 2026.
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