HCPCS code J2426 — Inj, invega sustenna, 1 mg. Status: Active. Effective Jul 1, 2023. Source: CMS HCPCS Level II.

J2426

Active

Inj, invega sustenna, 1 mg

Injection, paliperidone palmitate extended release (invega sustenna), 1 mg

Category: Drugs
Section: J-codes: Drugs Administered Other Than Oral Method
Effective: Jul 1, 2023
Code type: alphanumeric
OPPS Status: K — Non-pass-through drugs and biologicals
OPPS APC: 9255

MUE — Medically Unlikely Edits

Maximum units of J2426 Medicare will pay for one beneficiary on one date of service. Claims exceeding the MUE are denied or returned for review.

Service Type Max Units / Day
DME Supplier 0
Outpatient Hospital 1560
Practitioner Services 1560

Source: CMS Medicare NCCI Medically Unlikely Edits

NDC Crosswalk

National Drug Codes (NDCs) mapped to this HCPCS code.

NDC Drug Name
50458-0560-01 Invega Sustenna
50458-0561-01 Invega Sustenna
50458-0562-01 Invega Sustenna
50458-0563-01 Invega Sustenna
50458-0564-01 Invega Sustenna

Change History

Quarterly changes published by CMS. Revisions may affect the code description, coverage, or rate — review each quarter's changes before submitting claims.

  • Revised 2024-Q1
    Inj, invega sustenna, 1 mgj
    Inj, invega sustenna, 1 mg
  • New Code 2023-Q3
    Inj, invega sustenna, 1 mg
  • Revised 2023-Q3
    Paliperidone palmitate inj
    Inj, invega sustenna, 1 mgj