No. J0801 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 NDCs are billed under J0801?

CMS's ASP crosswalk for October 1, 2026 through December 31, 2026 lists 3 NDCs under J0801, for Acthar Gel and H.P. Acthar. The table on this page shows each one with its billing units per package.

What is the Medicare payment limit for J0801?

$3,884.267 per 40 units, 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.

J0801 J-Code: Acthar Gel, H.P. Acthar (corticotropin)

In short

J0801 is the HCPCS Level II code for injection, corticotropin (acthar gel), up to 40 units. CMS assigns NDCs for Acthar Gel and H.P. Acthar to it. The Medicare Part B payment limit is $3,884.267 per unit (October 1, 2026 through December 31, 2026).

Code

CMS HCPCS file

HCPCS codeJ0801

Billing unitSee descriptor

Descriptor: Injection, corticotropin (acthar gel), up to 40 units
Short descriptor: Inj. acthar gel to 40 units
Code set: HCPCS Level II, maintained by CMS
Effective: Oct 1, 2023

Medicare Part B payment limit

CMS ASP file

Payment limit per unit$3,884.267

Per40 units

Coinsurance20%

Effective October 1, 2026 through December 31, 2026. Payment allowance limits subject to the ASP methodology are based on 2Q26 ASP data. CMS note: "lesser of" methodology applied. 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.

NDCs billed under J0801

CMS’s ASP NDC–HCPCS crosswalk (effective October 1, 2026 through December 31, 2026) assigns 3 NDCs to J0801 for Acthar Gel and H.P. Acthar. Billing units per package are CMS’s figures for this code’s unit.

NDCs assigned to J0801 in the CMS ASP crosswalk
Drug	NDC (11-digit)	Labeler	Package	Billing units per package
Acthar Gel	63004-8711-04	Mallinckrodt ARD LLC	4 × 1	8
Acthar Gel	63004-8712-04	Mallinckrodt ARD LLC	4 × 1	4
H.P. Acthar	63004-8710-01	Mallinckrodt ARD LLC	5	10

J0801: common questions

Is J0801 a CPT code?: No. J0801 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 J0801?: CMS's ASP crosswalk for October 1, 2026 through December 31, 2026 lists 3 NDCs under J0801, for Acthar Gel and H.P. Acthar. The table on this page shows each one with its billing units per package.
What is the Medicare payment limit for J0801?: $3,884.267 per 40 units, 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.

J0801 — Injection, corticotropin (acthar gel), up to 40 units