In short

J0174 is the HCPCS Level II code for lecanemab-irmb, for intravenous injection, 1 mg. CMS assigns NDCs for Leqembi to it. One billing unit is 1 mg. The Medicare Part B payment limit is $1.361 per unit (October 1, 2026 through December 31, 2026).

Code

CMS HCPCS file
HCPCS codeJ0174
Billing unit1 mg
Descriptor
Lecanemab-irmb, for intravenous injection, 1 mg
Short descriptor
Lecanemab-irmb, for iv inj
Code set
HCPCS Level II, maintained by CMS
Effective
Apr 1, 2026

The billing unit is read from the descriptor. Confirm it against the CMS file before billing.

Medicare Part B payment limit

CMS ASP file
Payment limit per unit$1.361
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

Units and claim line

Units = dose given ÷ 1 mg. For example, 100 mg is 100 units. Enter the dose to get the units and the NDC line for the CMS-1500 and the 837P.

Enter the dose given to build the claim line.

NDCs billed under J0174

CMS’s ASP NDC–HCPCS crosswalk (effective October 1, 2026 through December 31, 2026) assigns 2 NDCs to J0174 for Leqembi. Billing units per package are CMS’s figures for this code’s unit.

NDCs assigned to J0174 in the CMS ASP crosswalk
DrugNDC (11-digit)LabelerPackageBilling units per package
Leqembi62856-0212-01Eisai Inc.2200
Leqembi62856-0215-01Eisai Inc.5500

J0174: common questions

Is J0174 a CPT code?
No. J0174 is a HCPCS Level II code, maintained by CMS, that identifies the drug supplied. CPT codes are five-digit numbers from the AMA that describe services. Giving the drug, for example an injection or infusion, is usually reported with a separate CPT administration code. CPT codes for drug administration.
What NDCs are billed under J0174?
CMS's ASP crosswalk for October 1, 2026 through December 31, 2026 lists 2 NDCs under J0174, for Leqembi. The table on this page shows each one with its billing units per package.
What is the Medicare payment limit for J0174?
$1.361 per 1 mg, effective October 1, 2026 through December 31, 2026, from CMS's Part B drug payment limit file. Multiply by the units billed for the allowed amount before deductible and coinsurance. It is not a coverage decision.
What is one billing unit of J0174?
One unit of J0174 is 1 mg, as stated in the code's descriptor. Units to report = dose given ÷ 1 mg. J-code billing units.

Free account

Keep searching with a free account

You’ve used your 3 free searches for this session. Log in or create a free Med-Code account to keep looking up NDCs, J-codes and drugs.

Create a free accountLog in