J0742 — Injection, imipenem 4 mg, cilastatin 4 mg and relebactam 2 mg
J0742 is a HCPCS Level II code for injection, imipenem 4 mg, cilastatin 4 mg and relebactam 2 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
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
Medically Unlikely Edits — units per day
The most units of J0742 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 500 units MAI 3 — Date of Service Edit: Clinical · Prescribing Information
- outpatient
- 500 units MAI 3 — Date of Service Edit: Clinical · Prescribing Information
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for J0742
- Long descriptor
- Injection, imipenem 4 mg, cilastatin 4 mg and relebactam 2 mg
- Short descriptor
- Inj imip 4 cilas 4 releb 2mg
- Added
- July 1, 2020
- BETOS
- O1E
- Pricing indicator
- 51 — Other
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.
Drugs.
Codes adjacent to J0742
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If J0742 is not quite right, the correct code is very often within a few positions of it.
- J0725Injection, chorionic gonadotropin, per 1,000 usp units
- J0735Injection, clonidine hydrochloride, 1 mg
- J0736Injection, clindamycin phosphate, 300 mg
- J0737Injection, clindamycin phosphate (baxter), not therapeutically equivalent to j0736, 300 mg
- J0738Injection, lenacapavir, 1 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)
- J0739Injection, cabotegravir, 1mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)
- J0740Injection, cidofovir, 375 mg
- J0741Injection, cabotegravir and rilpivirine, 2mg/3mg
- J0743Injection, cilastatin sodium; imipenem, per 250 mg
- J0744Injection, ciprofloxacin for intravenous infusion, 200 mg
- J0745Injection, codeine phosphate, per 30 mg
- J0750Emtricitabine 200mg and tenofovir disoproxil fumarate 300mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)
- J0751Emtricitabine 200mg and tenofovir alafenamide 25mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)
- J0752Oral, lenacapavir, 300 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)
- J0759Injection, clevidipine butyrate, 1 mg
- J0760Injection, colchicine, per 1 mgterminated
Questions about J0742
What is HCPCS code J0742?
J0742 is a HCPCS Level II code for injection, imipenem 4 mg, cilastatin 4 mg and relebactam 2 mg. It sits in the Drugs Administered Other Than Oral Method section.
Does Medicare cover J0742?
The CMS HCPCS file marks J0742 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 J0742 paid under the physician fee schedule?
J0742 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).