LEMTRADA J Code: J0202

Drug & Product Overview

HCPCS Descriptor Injection, alemtuzumab, 1 mg

HCPCS Added Date January 1, 2016

Manufacturer Genzyme

Route of Administration Intravenous

Generic Status Single-Source; Branded

Dosage Type Single-Dose

Dosage Form Injection, Solution, Concentrate

About LEMTRADA

Lemtrada is a medication aligned to the HCPCS J Code: J0202 for billing, pricing, and reimbursement purposes in the United States. It is a Neurology drug administered via the intravenous route and manufactured by Genzyme.

According to CMS Drug Use Information: Alemtuzumab is used to treat multiple sclerosis (MS). It is not a cure for MS but it is thought to help by preventing immune system cells (lymphocytes) from attacking the nerves in your brain and spinal cord. It helps decrease the number of relapses and may prevent or delay disability.

Disclaimer: This is a summary and does not contain all possible information about this product. For complete information about this product or your specific health needs, ask your healthcare professional.

NDC Code Information

Based on publicly available CMS files. The list of NDCs below is not exhaustive.

NDC Code	Drug	Manufacturer	Billing Units / Pkg	Package Size
58468-0200-01	Lemtrada	Genzyme Corporation	12	12 MG / 1.2 ML

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LEMTRADA Pricing & Reimbursement

J0202 Private Payer Reimbursement

$2,523.49 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

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Historical Graphing and Billing Calculator

per HCPCS unit

As of Q3 2026

LEMTRADA Claims Performance

Claims from Jan 2026 – Aug 2026

Claim Denial Rate 95.56%

Avg. Days to File 18.9days

Avg. Days to Pay 0.0days

Real-world claims performance from FocalPoint, OnPoint Oncology's reimbursement analytics platform, with claims data accrued at the clearing house level.

Explore J0202 claims analytics on FocalPoint →

LEMTRADA CPT Administration Codes

CPT Code	Description
96413	Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug
96415	Chemotherapy administration, intravenous infusion technique; each additional hour (List separately in addition to code for primary procedure)

JW / JZ modifiers apply

CMS has identified Lemtrada (J0202) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. Wastage billing guide →

LEMTRADA Medically Unlikely Edits (MUE)

The most billing units of J0202 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 1 mg.

Practitioner Office & Hospital Outpatient

12 units / day

= 12 mg per day

MAI 3 · Date of Service Edit: Clinical. Per-day limit based on clinical expectations; excess units are denied but may be appealed with documentation of medical necessity. See all MUE limits →

LEMTRADA Clinical Information

Indications and drug classification.

Treated Diseases & Conditions

This list of indications is not exhaustive and may be subject to errors. The information on BuyandBill.com is intended for informational purposes only and should not be used for medical advice.

Relapsing forms of multiple sclerosis, to include relapsing-remitting disease and active secondary progressive disease

Drug Class

CD52-directed Antibody Interactions [MoA]CD52-directed Cytolytic Antibody [EPC]

Frequently Asked Questions

Is there an available Lemtrada billing and coding guide?

Our team has not identified a manufacturer-published source of billing and coding information for LEMTRADA.

Are there any available Lemtrada patient assistance programs?

LEMTRADA patient assistance information can be found through Genzyme. Visit Here →

Where can I find Lemtrada prescribing information?

LEMTRADA prescribing information can be found at the link below: Visit Here →

Where can I find Lemtrada side effect information?

Information regarding LEMTRADA's side effects can be found at MedlinePlus Visit Here →

Does billing LEMTRADA require JZ/JW wastage modifiers?

CMS has identified LEMTRADA(J0202) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. See CMS guidelines on use of the JZ and JW wastage modifiers below.

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