J0174 — Lecanemab-irmb, for intravenous injection, 1 mg
J0174 is a HCPCS Level II code for lecanemab-irmb, for intravenous injection, 1 mg. It belongs to the Drugs Administered Other Than Oral Method section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Carrier judgment
Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusE
Excluded from the physician fee schedule by regulation. Payment, where it exists, comes from another fee schedule (drugs via ASP, supplies via DMEPOS, and so on).
Global period: XXX
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The CMS record for J0174
- Long descriptor
- Lecanemab-irmb, for intravenous injection, 1 mg
- Short descriptor
- Lecanemab-irmb, for iv inj
- Added
- July 6, 2023
- BETOS
- O1E
- Pricing indicator
- 00 — Not priced by Part B
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Service not separately priced by Part B — not covered, bundled into another service, or used by Part A only.
Codes adjacent to J0174
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If J0174 is not quite right, the correct code is very often within a few positions of it.
- J0165Injection, epinephrine, not otherwise specified, 0.1 mg
- J0166Injection, epinephrine (bpi), not therapeutically equivalent to j0165, 0.1 mg
- J0167Injection, epinephrine (hospira), not therapeutically equivalent to j0165, 0.1 mg
- J0168Injection, epinephrine (international medication systems), not therapeutically equivalent to j0165, 0.1 mg
- J0169Injection, epinephrine (adrenalin), not therapeutically equivalent to j0165, 0.1 mg
- J0171Injection, adrenalin, epinephrine, 0.1 mgterminated
- J0172Injection, aducanumab-avwa, 2 mgterminated
- J0173Injection, epinephrine (belcher), not therapeutically equivalent to j0171, 0.1 mgterminated
- J0175Injection, donanemab-azbt, 2 mg
- J0177Injection, aflibercept hd, 1 mg
- J0178Injection, aflibercept, 1 mg
- J0179Injection, brolucizumab-dbll, 1 mg
- J0180Injection, agalsidase beta, 1 mg
- J0184Injection, amisulpride, 1 mg
- J0185Injection, aprepitant, 1 mg
- J0190Injection, biperiden lactate, per 5 mgterminated
Questions about J0174
What is HCPCS code J0174?
J0174 is a HCPCS Level II code for lecanemab-irmb, for intravenous injection, 1 mg. It sits in the Drugs Administered Other Than Oral Method section.
Does Medicare cover J0174?
The CMS HCPCS file marks J0174 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
How is J0174 paid under the physician fee schedule?
J0174 carries PFS status code E. Excluded from the physician fee schedule by regulation. Payment, where it exists, comes from another fee schedule (drugs via ASP, supplies via DMEPOS, and so on).