Modifier and HCPCS Changes for April 2025 - JE Part B
Modifier and HCPCS Changes for April 2025
The following new and deleted National Level II modifiers and Healthcare Common Procedure Coding System (HCPCS) are effective for dates of service on/after April 1, 2025.
In compliance with the Health Insurance Portability and Accountability Act (HIPAA), CMS eliminated the 3-month grace period for discontinued codes in Change Request (CR) 3093 dated February 6, 2004. Effective for dates of services on/after January 1, 2010, there is no grace period for billing discontinued HCPCS codes.
Note: The inclusion of modifiers or codes on this web page do not necessarily indicate coverage. New modifiers and HCPCS identified as Durable Medical Equipment (DME) are not included in this listing.
New Modifiers
There are no new modifiers being implemented.
New Codes
| HCPCS | DESCRIPTION |
|---|---|
| A2030 | Miro3d fibers, per milligram |
| A2031 | Mirodry wound matrix, per square centimeter |
| A2032 | Myriad matrix, per square centimeter |
| A2033 | Myriad morcells, 4 milligrams |
| A2034 | Foundation drs solo, per square centimeter |
| A2035 | Corplex p or theracor p or allacor p, per milligram |
| A9611 | Flurpiridaz f 18, diagnostic, 1 millicurie |
| C8004 | Simulation angiogram with use of a pressure-generating catheter (e.g., one-way valve, intermittently occluding), inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the angiogram, for subsequent therapeutic radioembolization of tumors |
| C8005 | Bronchoscopy, rigid or flexible, non-thermal transbronchial ablation of lesion(s) by pulsed electric field (pef) energy, including fluoroscopic and/or ultrasound guidance, when performed, with computed tomography acquisition(s) and 3d rendering, computer-assisted, image-guided navigation, and endobronchial ultrasound (ebus) guided transtracheal and/or transbronchial sampling (e.g., aspiration[s]/biopsy[ies]) of all mediastinal and/or hilar lymph node stations or structures, and therapeutic intervention(s) |
| C9300 | Injection, indigotindisulfonate sodium, 1 mg |
| C9301 | Obecabtagene autoleucel, up to 410 million cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose |
| C9302 | Injection, zanidatamab-hrii, 2 mg |
| C9303 | Injection, zolbetuximab-clzb, 1 mg |
| C9304 | Injection, marstacimab-hncq, 0.5 mg |
| G0183 | Quantitative software measurements of cardiac volume, cardiac chambers volumes and left ventricular wall mass derived from ct scan(s) data of the chest/heart (with or without contrast) |
| G0566 | 3d radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy |
| G0566 | 3d radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy |
| G0566 | 3d radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy |
| G0567 | Infectious agent detection by nucleic acid (dna or rna); hepatitis c, screening, amplified probe technique |
| J0281 | Injection, aminocaproic acid, 1 gram |
| J1072 | Injection, testosterone cypionate (azmiro), 1 mg |
| J1271 | Injection, doxycycline hyclate, 1 mg |
| J1299 | Injection, eculizumab, 2 mg |
| J1308 | Injection, famotidine, 0.25 mg |
| J1808 | Injection, folic acid, 0.1 mg |
| J1938 | Injection, furosemide, 1 mg |
| J2351 | Injection, ocrelizumab, 1 mg and hyaluronidase-ocsq |
| J2428 | Injection, paliperidone palmitate extended release (erzofri), 1 mg |
| J2804 | Injection, rifampin, 1 mg |
| J2865 | Injection, sulfamethoxazole 5 mg and trimethoprim 1 mg |
| J7521 | Tacrolimus, granules, oral suspension, 0.1 mg |
| J9024 | Injection, atezolizumab, 5 mg and hyaluronidase-tqjs |
| J9038 | Injection, axatilimab-csfr, 0.1 mg |
| J9054 | Injection, bortezomib (boruzu), 0.1 mg |
| J9161 | Injection, denileukin diftitox-cxdl, 1 mcg |
| Q2057 | Afamitresgene autoleucel, including leukapheresis and dose preparation procedures, per therapeutic dose |
| Q4354 | Palingen dual-layer membrane, per square centimeter |
| Q4355 | Abiomend xplus membrane and abiomend xplus hydromembrane, per square centimeter |
| Q4356 | Abiomend membrane and abiomend hydromembrane, per square centimeter |
| Q4357 | Xwrap plus, per square centimeter |
| Q4358 | Xwrap dual, per square centimeter |
| Q4359 | Choriply, per square centimeter |
| Q4360 | Amchoplast fd, per square centimeter |
| Q4361 | Epixpress, per square centimeter |
| Q4362 | Cygnus disk, per square centimeter |
| Q4363 | Amnio burgeon membrane and hydromembrane, per square centimeter |
| Q4364 | Amnio burgeon xplus membrane and xplus hydromembrane, per square centimeter |
| Q4365 | Amnio burgeon dual-layer membrane, per square centimeter |
| Q4366 | Dual layer amnio burgeon x-membrane, per square centimeter |
| Q4367 | Amniocore sl, per square centimeter |
| Q5147 | Injection, aflibercept-ayyh (pavblu), biosimilar, 1 mg |
| Q5148 | Injection, filgrastim-txid (nypozi), biosimilar, 1 microgram |
| Q5149 | Injection, aflibercept-abzv (enzeevu), biosimilar, 1 mg |
| Q5150 | Injection, aflibercept-mrbb (ahzantive), biosimilar, 1 mg |
| Q5151 | Injection, eculizumab-aagh (epysqli), biosimilar, 2 mg |
| Q5152 | Injection, eculizumab-aeeb (bkemv), biosimilar, 2 mg |
| Q9999 | Injection, ustekinumab-aauz (otulfi), biosimilar, 1 mg |
Deleted Codes
| HCPCS | DESCRIPTION |
|---|---|
| A9155 | Artificial saliva, 30 ml |
| G0564 | Creation of subcutaneous pocket with insertion of 365 day implantable interstitial glucose sensor, including system activation and patient training |
| G0565 | Removal of implantable interstitial glucose sensor with creation of subcutaneous pocket at different anatomic site and insertion of new 365 day implantable sensor, including system activation |
| J1094 | Injection, dexamethasone acetate, 1 mg |
| J1300 | Injection, eculizumab, 10 mg |
| J1810 | Injection, droperidol and fentanyl citrate, up to 2 ml ampule |
| J1890 | Injection, cephalothin sodium, up to 1 gram |
| J1940 | Injection, furosemide, up to 20 mg |
| J9037 | Injection, belantamab mafodotin-blmf, 0.5 mg |
| J9247 | Injection, melphalan flufenamide, 1mg |
| M0220 | Injection, tixagevimab and cilgavimab, for the pre-exposure prophylaxis only, for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) with no known sars-cov-2 exposure, who either have moderate to severely compromised immune systems or for whom vaccination with any available covid-19 vaccine is not recommended due to a history of severe adverse reaction to a covid-19 vaccine(s) and/or covid-19 vaccine component(s), includes injection and post administration monitoring |
| M0221 | Injection, tixagevimab and cilgavimab, for the pre-exposure prophylaxis only, for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) with no known sars-cov-2 exposure, who either have moderate to severely compromised immune systems or for whom vaccination with any available covid-19 vaccine is not recommended due to a history of severe adverse reaction to a covid-19 vaccine(s) and/or covid-19 vaccine component(s), includes injection and post administration monitoring in the home or residence; this includes a beneficiary's home that has been made provider-based to the hospital during the covid-19 public health emergency |
| M0222 | Intravenous injection, bebtelovimab, includes injection and post administration monitoring |
| M0223 | Intravenous injection, bebtelovimab, includes injection and post administration monitoring in the home or residence; this includes a beneficiary's home that has been made provider-based to the hospital during the covid-19 public health emergency |
| M0240 | Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring, subsequent repeat doses |
| M0241 | Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring in the home or residence; this includes a beneficiary's home that has been made provider-based to the hospital during the covid-19 public health emergency, subsequent repeat doses |
| M0243 | Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
| M0244 | Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring in the home or residence; this includes a beneficiary's home that has been made provider-based to the hospital during the covid-19 public health emergency |
| M0245 | Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring |
| M0246 | Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring in the home or residence; this includes a beneficiary's home that has been made provider based to the hospital during the covid 19 public health emergency |
| M0247 | Intravenous infusion, sotrovimab, includes infusion and post administration monitoring |
| Q0220 | Injection, tixagevimab and cilgavimab, for the pre-exposure prophylaxis only, for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) with no known sars-cov-2 exposure, who either have moderate to severely compromised immune systems or for whom vaccination with any available covid-19 vaccine is not recommended due to a history of severe adverse reaction to a covid-19 vaccine(s) and/or covid-19 vaccine component(s), 300 mg |
| Q0221 | Injection, tixagevimab and cilgavimab, for the pre-exposure prophylaxis only, for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) with no known sars-cov-2 exposure, who either have moderate to severely compromised immune systems or for whom vaccination with any available covid-19 vaccine is not recommended due to a history of severe adverse reaction to a covid-19 vaccine(s) and/or covid-19 vaccine component(s), 600 mg |
| Q0222 | Injection, bebtelovimab, 175 mg |
| Q0240 | Injection, casirivimab and imdevimab, 600 mg |
| Q0243 | Injection, casirivimab and imdevimab, 2400 mg |
| Q0244 | Injection, casirivimab and imdevimab, 1200 mg |
| Q0245 | Injection, bamlanivimab and etesevimab, 2100 mg |
| Q0247 | Injection, sotrovimab, 500 mg |
| Q4231 | Corplex p, per cc |
| Q5139 | Injection, eculizumab-aeeb (bkemv), biosimilar, 10 mg |
Source
Transmittal 12977, CR 13836 dated November 21, 2024
Last Updated Mar 26 , 2025
