HCPCS drug code · CMS crosswalk
Imaavy J-Code / HCPCS Code
In short
Imaavy is billed under HCPCS J9256 — Injection, nipocalimab-aahu, 3 mg. One billing unit is 3 mg. CMS's crosswalk lists 2 Imaavy NDCs under this code.
Reference
- J9256
- Injection, nipocalimab-aahu, 3 mgBilling unit: 3 mg
- Labelers
- Janssen Biotech, Inc.
Medicare Part B payment limit
CMS ASP filePayment limit per unit$32.321
Per3 mg
Coinsurance20%
Effective October 1, 2026 through December 31, 2026. Payment allowance limits subject to the ASP methodology are based on 2Q26 ASP data. A payment limit is not a coverage decision; the Medicare contractor decides coverage. CMS ASP pricing files
Imaavy units and claim line
Enter the dose given to get the J9256 units and the NDC line for the CMS-1500 and the 837P.
Enter the dose given to build the claim line.
Imaavy 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 |
|---|---|---|---|---|
| 57894-0800-01 | J9256 | Janssen Biotech, Inc. | 1.62 | 100 |
| 57894-0801-01 | J9256 | Janssen Biotech, Inc. | 6.5 | 400 |
Imaavy: common questions
- What is the J-code for Imaavy?
- Imaavy is billed under HCPCS J9256 — Injection, nipocalimab-aahu, 3 mg. One billing unit is 3 mg. CMS's crosswalk lists 2 Imaavy NDCs under this code.
- How many J9256 billing units are in a package of Imaavy?
- CMS lists 100 to 400 billing units per package, depending on the NDC, where one unit is 3 mg. Units to report are based on the dose given, not the package.
- Is J9256 a CPT code?
- No. J9256 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.