In short

Invega Sustenna is billed under HCPCS J2426 — Injection, paliperidone palmitate extended release (invega sustenna), 1 mg. One billing unit is 1 mg. CMS's crosswalk lists 5 Invega Sustenna NDCs under this code.

J2426 code details

Reference

J2426
Injection, paliperidone palmitate extended release (invega sustenna), 1 mgBilling unit: 1 mg
Labelers
Janssen Pharmaceuticals, Inc.

Medicare Part B payment limit

CMS ASP file
Payment limit per unit$15.437
Per1 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

Invega Sustenna units and claim line

Enter the dose given to get the J2426 units and the NDC line for the CMS-1500 and the 837P.

Enter the dose given to build the claim line.

Invega Sustenna 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.

Invega Sustenna NDCs in the CMS ASP crosswalk
NDC (11-digit)HCPCSLabelerPackageBilling units per package
50458-0560-01J2426Janssen Pharmaceuticals, Inc.0.2539
50458-0561-01J2426Janssen Pharmaceuticals, Inc.0.578
50458-0562-01J2426Janssen Pharmaceuticals, Inc.0.75117
50458-0563-01J2426Janssen Pharmaceuticals, Inc.1156
50458-0564-01J2426Janssen Pharmaceuticals, Inc.1.5234

Invega Sustenna: common questions

What is the J-code for Invega Sustenna?
Invega Sustenna is billed under HCPCS J2426 — Injection, paliperidone palmitate extended release (invega sustenna), 1 mg. One billing unit is 1 mg. CMS's crosswalk lists 5 Invega Sustenna NDCs under this code.
How many J2426 billing units are in a package of Invega Sustenna?
CMS lists 39 to 234 billing units per package, depending on the NDC, where one unit is 1 mg. Units to report are based on the dose given, not the package.
Is J2426 a CPT code?
No. J2426 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.

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