HCPCS drug code · CMS crosswalk
Sunlenca J-Code / HCPCS Code
In short
Sunlenca is billed under HCPCS J1961 — Injection, lenacapavir (only for use as hiv treatment), 1 mg. One billing unit is 1 mg. CMS's crosswalk lists 2 Sunlenca NDCs under this code.
Reference
- J1961
- Injection, lenacapavir (only for use as hiv treatment), 1 mgBilling unit: 1 mg
- Labelers
- Gilead Sciences, Inc.
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. A payment limit is not a coverage decision; the Medicare contractor decides coverage. CMS ASP pricing files
Sunlenca units and claim line
Enter the dose given to get the J1961 units and the NDC line for the CMS-1500 and the 837P.
Enter the dose given to build the claim line.
Sunlenca 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 |
|---|---|---|---|---|
| 61958-3002-01 | J1961 | Gilead Sciences, Inc. | 2 × 1.5 | 927 |
| 61958-3005-01 | J1961 | Gilead Sciences, Inc. | 2 × 1.5 | 927 |
Sunlenca: common questions
- What is the J-code for Sunlenca?
- Sunlenca is billed under HCPCS J1961 — Injection, lenacapavir (only for use as hiv treatment), 1 mg. One billing unit is 1 mg. CMS's crosswalk lists 2 Sunlenca NDCs under this code.
- How many J1961 billing units are in a package of Sunlenca?
- CMS lists 927 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 J1961 a CPT code?
- No. J1961 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.