HCPCS drug code · CMS crosswalk
Acthar Gel J-Code / HCPCS Code
In short
Acthar Gel is billed under HCPCS J0801 — Injection, corticotropin (acthar gel), up to 40 units. One billing unit is up to 40 units. CMS's crosswalk lists 2 Acthar Gel NDCs under this code.
Reference
- J0801
- Injection, corticotropin (acthar gel), up to 40 unitsBilling unit: up to 40 units
- Labelers
- Mallinckrodt ARD LLC
Medicare Part B payment limit
CMS ASP fileEffective October 1, 2026 through December 31, 2026. Payment allowance limits subject to the ASP methodology are based on 2Q26 ASP data. CMS note: "lesser of" methodology applied. A payment limit is not a coverage decision; the Medicare contractor decides coverage. CMS ASP pricing files
Acthar Gel units and claim line
Enter the dose given to get the J0801 units and the NDC line for the CMS-1500 and the 837P.
Enter the units to build the claim line.
Acthar Gel NDCs and billing units
From CMS’s ASP NDC–HCPCS crosswalk, effective October 1, 2026 through December 31, 2026. Billing units per package are CMS’s figures for the code’s unit.
| NDC (11-digit) | HCPCS | Labeler | Package | Billing units per package |
|---|---|---|---|---|
| 63004-8711-04 | J0801 | Mallinckrodt ARD LLC | 4 × 1 | 8 |
| 63004-8712-04 | J0801 | Mallinckrodt ARD LLC | 4 × 1 | 4 |
Acthar Gel: common questions
- What is the J-code for Acthar Gel?
- Acthar Gel is billed under HCPCS J0801 — Injection, corticotropin (acthar gel), up to 40 units. One billing unit is up to 40 units. CMS's crosswalk lists 2 Acthar Gel NDCs under this code.
- How many J0801 billing units are in a package of Acthar Gel?
- CMS lists 4 to 8 billing units per package, depending on the NDC, where one unit is up to 40 units. Units to report are based on the dose given, not the package.
- Is J0801 a CPT code?
- No. J0801 is a HCPCS Level II code from CMS for the drug itself. Giving it, for example by injection or infusion, is usually reported with a separate CPT administration code.