2026 HCPCS Code Update - January Edition - Correct Coding - JA DME
2026 HCPCS Code Update - January Edition - Correct Coding
Joint DME MAC and PDAC Publication
Posted December 18, 2025
The following tables identify changes to Level II Healthcare Common Procedure Coding System (HCPCS) codes for January 2026. The tables contain only HCPCS codes applicable to items within Medicare DME MAC jurisdiction. There may be other HCPCS code changes for items under the jurisdiction of other Medicare contractors. Consult those contractors for information regarding HCPCS codes within their areas of responsibility.
All HCPCS code changes are effective for claims with dates of service on or after January 1, 2026.
Code Change Categories
- Added Codes/Modifiers: Identifies newly created codes and modifiers. Listing of a code in the tables does not necessarily indicate coverage. Refer to the applicable Local Coverage Determination for information regarding Medicare reimbursement requirements.
- Discontinued Codes/Deleted Modifiers: Identifies codes and modifiers discontinued or deleted in the new cycle. These codes and modifiers continue to be valid for Medicare claims with dates of service either on or before December 31, 2025. There is no grace period for submission of a discontinued code/modifier for claims with dates of service after its effective end date. If there is a direct crosswalk for a discontinued/deleted code or modifier, the crosswalk code will be displayed in a table.
- Narrative Changes: Identifies changes in the narrative descriptor for an existing code or modifier.
Added Codes
Urological Supplies
| Code | Narrative |
|---|---|
| A4295 | INTERMITTENT URINARY CATHETER; STRAIGHT TIP, HYDROPHILIC COATING, EACH |
| A4296 | INTERMITTENT URINARY CATHETER; COUDE (CURVED) TIP, HYDROPHILIC COATING, EACH |
| A4297 | INTERMITTENT URINARY CATHETER; HYDROPHILIC COATING, WITH INSERTION SUPPLIES |
Immunosuppressive Drugs
| Code | Narrative |
|---|---|
| J7528 | MYCOPHENOLATE MOFETIL, FOR SUSPENSION, ORAL, 100 MG |
Miscellaneous
| Code | Narrative |
|---|---|
| J0162 | INJECTION, EPINEPHRINE (FRESENIUS), NOT THERAPEUTICALLY EQUIVALENT TO J0165, 0.1 MG |
| J0654 | INJECTION, LIOTHYRONINE, 1 MCG |
| J1736 | INJECTION, MELOXICAM (DELOVA), 1 MG |
| J1737 | INJECTION, MELOXICAM (AZURITY), 1 MG |
| J1837 | INJECTION, POSACONAZOLE, 1 MG |
| J2516 | INJECTION, PENTAMIDINE ISETHIONATE, 1 MG |
| J2596 | INJECTION, VASOPRESSIN (LONG GROVE), NOT THERAPEUTICALLY EQUIVALENT TO J2598, 1 UNIT |
| J3291 | INJECTION, TRANEXAMIC ACID IN SODIUM CHLORIDE, 5 MG |
| J3376 | INJECTION, VANCOMYCIN HCL (HIKMA), NOT THERAPEUTICALLY EQUIVALENT TO J3373, 10 MG |
| J3379 | INJECTION, VALPROATE SODIUM, 5 MG |
| J3387 | INJECTION, ELIVALDOGENE AUTOTEMCEL, PER TREATMENT |
| J9184 | INJECTION, GEMCITABINE HYDROCHLORIDE (AVYXA), 200 MG |
| J9256 | INJECTION, NIPOCALIMAB-AAHU, 3 MG |
| Q5160 | INJECTION, BEVACIZUMAB-NWGD (JOBEVNE), BIOSIMILAR, 10 MG |
Discontinued Codes
External Infusion Pumps
| Code | Narrative |
|---|---|
| J0288 | INJECTION, AMPHOTERICIN B CHOLESTERYL SULFATE COMPLEX, 10 MG |
| J1457 | INJECTION, GALLIUM NITRATE, 1 MG |
| J1562 | INJECTION, IMMUNE GLOBULIN (VIVAGLOBIN), 100 MG |
Immunosuppressive Drugs
| Code | Narrative |
|---|---|
| J7505 | MUROMONAB-CD3, PARENTERAL, 5 MG |
| J7513 | DACLIZUMAB, PARENTERAL, 25 MG |
Intravenous Immune Globulin
| Code | Narrative |
|---|---|
| J1572 | INJECTION, IMMUNE GLOBULIN, (FLEBOGAMMA/FLEBOGAMMA DIF), INTRAVENOUS, NON-LYOPHILIZED (E.G., LIQUID), 500 MG |
Oral Anticancer Drugs
| Code | Narrative |
|---|---|
| J8562 | FLUDARABINE PHOSPHATE, ORAL, 10 MG |
Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics)
| Code | Narrative |
|---|---|
| J8650 | NABILONE, ORAL, 1 MG |
| Q0174 | THIETHYLPERAZINE MALEATE, 10 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE REGIMEN |
Miscellaneous
| Code | Narrative |
|---|---|
| J0172 | INJECTION, ADUCANUMAB-AVWA, 2 MG |
| J0190 | INJECTION, BIPERIDEN LACTATE, PER 5 MG |
| J0200 | INJECTION, ALATROFLOXACIN MESYLATE, 100 MG |
| J0205 | INJECTION, ALGLUCERASE, PER 10 UNITS |
| J0215 | INJECTION, ALEFACEPT, 0.5 MG |
| J0350 | INJECTION, ANISTREPLASE, PER 30 UNITS |
| J0365 | INJECTION, APROTONIN, 10,000 KIU |
| J0380 | INJECTION, METARAMINOL BITARTRATE, PER 10 MG |
| J0395 | INJECTION, ARBUTAMINE HCL, 1 MG |
| J0710 | INJECTION, CEPHAPIRIN SODIUM, UP TO 1 GM |
| J0715 | INJECTION, CEFTIZOXIME SODIUM, PER 500 MG |
| J0795 | INJECTION, CORTICORELIN OVINE TRIFLUTATE, 1 MICROGRAM |
| J0889 | DAPRODUSTAT, ORAL, 1 MG, (FOR ESRD ON DIALYSIS) |
| J1267 | INJECTION, DORIPENEM, 10 MG |
| J1330 | INJECTION, ERGONOVINE MALEATE, UP TO 0.2 MG |
| J1443 | INJECTION, FERRIC PYROPHOSPHATE CITRATE SOLUTION (TRIFERIC), 0.1 MG OF IRON |
| J1444 | INJECTION, FERRIC PYROPHOSPHATE CITRATE POWDER, 0.1 MG OF IRON |
| J1445 | INJECTION, FERRIC PYROPHOSPHATE CITRATE SOLUTION (TRIFERIC AVNU), 0.1 MG OF IRON |
| J1452 | INJECTION, FOMIVIRSEN SODIUM, INTRAOCULAR, 1.65 MG |
| J1620 | INJECTION, GONADORELIN HYDROCHLORIDE, PER 100 MCG |
| J1655 | INJECTION, TINZAPARIN SODIUM, 1000 IU |
| J1710 | INJECTION, HYDROCORTISONE SODIUM PHOSPHATE, UP TO 50 MG |
| J1945 | INJECTION, LEPIRUDIN, 50 MG |
| J2504 | INJECTION, PEGADEMASE BOVINE, 25 IU |
| J2513 | INJECTION, PENTASTARCH, 10% SOLUTION, 100 ML |
| J2910 | INJECTION, AUROTHIOGLUCOSE, UP TO 50 MG |
| J2940 | INJECTION, SOMATREM, 1 MG |
| J2995 | INJECTION, STREPTOKINASE, PER 250,000 IU |
| J3280 | INJECTION, THIETHYLPERAZINE MALEATE, UP TO 10 MG |
| J3305 | INJECTION, TRIMETREXATE GLUCURONATE, PER 25 MG |
| J3310 | INJECTION, PERPHENAZINE, UP TO 5 MG |
| J3320 | INJECTION, SPECTINOMYCIN DIHYDROCHLORIDE, UP TO 2 GM |
| J3355 | INJECTION, UROFOLLITROPIN, 75 IU |
| J3364 | INJECTION, UROKINASE, 5000 IU VIAL |
| J3365 | INJECTION, IV, UROKINASE, 250,000 I.U. VIAL |
| J3400 | INJECTION, TRIFLUPROMAZINE HCL, UP TO 20 MG |
| J9019 | INJECTION, ASPARAGINASE (ERWINAZE), 1,000 IU |
| J9020 | INJECTION, ASPARAGINASE, NOT OTHERWISE SPECIFIED, 10,000 UNITS |
| J9098 | INJECTION, CYTARABINE LIPOSOME, 10 MG |
| J9151 | INJECTION, DAUNORUBICIN CITRATE, LIPOSOMAL FORMULATION, 10 MG |
| J9165 | INJECTION, DIETHYLSTILBESTROL DIPHOSPHATE, 250 MG |
| J9212 | INJECTION, INTERFERON ALFACON-1, RECOMBINANT, 1 MICROGRAM |
| J9270 | INJECTION, PLICAMYCIN, 2.5 MG |
| Q5109 | INJECTION, INFLIXIMAB-QBTX, BIOSIMILAR, (IXIFI), 10 MG |
Narrative Changes
Urological Supplies
| Code | Old Narrative | New Narrative |
|---|---|---|
| A4351 | INTERMITTENT URINARY CATHETER; STRAIGHT TIP, WITH OR WITHOUT COATING (TEFLON, SILICONE, SILICONE ELASTOMER, OR HYDROPHILIC, ETC.), EACH | INTERMITTENT URINARY CATHETER; STRAIGHT TIP, WITH OR WITHOUT COATING (TEFLON, SILICONE, OR SILICONE ELASTOMER, ETC.), EACH |
| A4352 | INTERMITTENT URINARY CATHETER; COUDE (CURVED) TIP, WITH OR WITHOUT COATING (TEFLON, SILICONE, SILICONE ELASTOMERIC, OR HYDROPHILIC, ETC.), EACH | INTERMITTENT URINARY CATHETER; COUDE (CURVED) TIP, WITH OR WITHOUT COATING (TEFLON, SILICONE, OR SILICONE ELASTOMERIC, ETC.), EACH |
Refer to the Centers for Medicare and Medicaid Services (CMS) website to download a full listing of HCPCS code additions, revisions, deletions, etc. in an excel file.
For questions about correct coding or products not listed on the DMECS Product Classification List (PCL), contact the PDAC HCPCS Helpline at (877) 735-1326 during the hours of 9:30 a.m. to 5:00 p.m. ET, Monday through Friday. You may also visit the PDAC website to chat with a representative or select the Contact Us button at the top of the PDAC website for email, FAX, or postal mail information.
Revision History
| Date of Change | Description |
|---|---|
| 12/18/2025 | Originally Published |
Last Updated Dec 18 , 2025
