Tezspire J Code: J2356
Injection, tezepelumab-ekko, 1 mg
Q4 2026 Medicare Payment Limit for J2356, effective October 1, 2026: $17.839 per HCPCS billing unit, down 0.5% from $17.92. From CMS's final file.
Drug & Product Overview
About Tezspire
Tezspire is a medication aligned to the HCPCS J Code: J2356 for billing, pricing, and reimbursement purposes in the United States. It is an Anti-Eosinophil Asthma drug administered via the subcutaneous route and manufactured by Amgen.
According to CMS Drug Use Information: This medication is used with other medications to control and prevent symptoms of severe asthma (such as wheezing and shortness of breath). Controlling symptoms of asthma helps you maintain your normal activities and decreases time lost from work or school. Tezepelumab may also be used to reduce symptoms caused by nasal polyps and the long-term swelling of the sinuses and nasal passage (chronic rhinosinusitis with nasal polyps). Tezepelumab belongs to a class of medications known as monoclonal antibodies. It helps reduce swelling (inflammation) in the airways of the lungs to make breathing easier. It may also help reduce the size of nasal polyps and lessen symptoms such as stuffy nose and loss of smell. This medication must be used regularly to be effective. It does not work right away and should not be used to relieve sudden asthma attacks or breathing problems. If an asthma attack occurs, use your quick-relief inhaler as prescribed.
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 |
|---|---|---|---|---|
| 55513-0112-01 | Tezspire | Amgen Inc | 210 | 210 MG / 1.9 ML |
| 55513-0123-01 | Tezspire | Amgen Inc | 210 | 210 MG / 1.9 ML |
Tezspire Pricing & Reimbursement
National median reimbursement across major commercial payers.
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The below list of CPT codes is intended for informational purposes only and may not be exhaustive. CPT® codes and descriptions are copyright American Medical Association (AMA). All rights reserved.
| CPT Code | Description |
|---|---|
| 96372 | Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intramuscular |
CMS has identified Tezspire (J2356) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. Wastage billing guide →
Tezspire Medically Unlikely Edits (MUE)
The most billing units of J2356 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 1 mg.
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 →
Tezspire Clinical Information
Indications and drug classification.
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.
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Frequently Asked Questions
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