TZIELD J Code: J9381

Drug & Product Overview

HCPCS Descriptor Injection, teplizumab-mzwv, 5 mcg

HCPCS Added Date July 1, 2023

Manufacturer Sanofi

Route of Administration Intravenous

Generic Status Single-Source; Branded

Dosage Type Single-Dose

Dosage Form Injection

About TZIELD

Tzield is a medication aligned to the HCPCS J Code: J9381 for billing, pricing, and reimbursement purposes in the United States. This Misc. medication is administered via the intravenous route and manufactured by Sanofi.

According to CMS Drug Use Information: Teplizumab is used to slow down the worsening of type 1 diabetes. It may delay the need to use insulin to treat your type 1 diabetes. Teplizumab belongs to a class of drugs known as monoclonal antibodies. It works by preventing your immune system from attacking your pancreas, which makes insulin in your body.

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. Showing 1 of 3 NDCs — log in for the full crosswalk.

NDC Code	Drug	Manufacturer	Billing Units / Pkg	Package Size
73650-0316-01	Tzield	Provention Bio, Inc.	400	2000 MCG / 2 ML
•••••-••••-•• Log in to view	TZIELD
	TZIELD

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TZIELD Pricing & Reimbursement

J9381 Private Payer Reimbursement

$38.47 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

Create an account on PayerPrice for more information →

Historical Graphing and Billing Calculator

per HCPCS unit

As of Q4 2026

TZIELD Claims Performance

Claims from Jan 2026 – Aug 2026

Claim Denial Rate 32.27%

Avg. Days to File 6.6days

Avg. Days to Pay 24.3days

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

Explore J9381 claims analytics on FocalPoint →

TZIELD 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 Tzield (J9381) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. Wastage billing guide →

TZIELD Medically Unlikely Edits (MUE)

The most billing units of J9381 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 5 mcg.

Practitioner Office & Hospital Outpatient

800 units / day

= 4,000 mcg 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 →

TZIELD 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.

Stage 2 type 1 diabetes Stage 3 type 1 diabetes

Drug Class

CD3-directed Antibody Interactions [MoA]CD3-directed Antibody [EPC]

Frequently Asked Questions

Is there an available Tzield billing and coding guide?

Billing and coding information for TZIELD can be found through Provention Bio, Inc.. Visit Here →

Are there any available Tzield patient assistance programs?

TZIELD patient assistance information can be found through Provention Bio, Inc.. Visit Here →

Where can I find Tzield prescribing information?

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

Where can I find Tzield side effect information?

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

Does billing TZIELD require JZ/JW wastage modifiers?

CMS has identified TZIELD(J9381) 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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