No. J0751 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.

What is the Medicare payment limit for J0751?

$74.941 per 200 mg/25 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.

J0751 HCPCS Code — Hiv prep, ftc/taf 200/25mg

In short

J0751 is the HCPCS Level II code for emtricitabine 200mg and tenofovir alafenamide 25mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv). The Medicare Part B payment limit is $74.941 per unit (October 1, 2026 through December 31, 2026).

Code

CMS HCPCS file

HCPCS codeJ0751

Billing unitSee descriptor

Descriptor: Emtricitabine 200mg and tenofovir alafenamide 25mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)
Short descriptor: Hiv prep, ftc/taf 200/25mg
Code set: HCPCS Level II, maintained by CMS
Effective: Jan 1, 2025

Medicare Part B payment limit

CMS ASP file

Payment limit per unit$74.941

Per200 mg/25 mg

Coinsurance0%

Effective October 1, 2026 through December 31, 2026. Payment allowance limits subject to the ASP methodology are based on 2Q26 ASP data. CMS note: HIV PrEP drug. A payment limit is not a coverage decision; the Medicare contractor decides coverage. CMS ASP pricing files

Units and claim line

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

HCPCS units

Modifier

NDC (11-digit)

NDC unit qualifier

NDC quantity

Enter the units to build the claim line.

Find the NDC

Med-Code hasn’t mapped J0751 to specific products yet. Search the FDA NDC Directory for the drug named in the descriptor, and check the route and strength match the code.

Search NDCs for Emtricitabine 200mg and tenofovir alafenamide 25mg

J0751: common questions

Is J0751 a CPT code?: No. J0751 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 is the Medicare payment limit for J0751?: $74.941 per 200 mg/25 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.

J0751 — Emtricitabine 200mg and tenofovir alafenamide 25mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)