J1105: Dexmedetomidine, oral, 1 mcg
J1105 is a HCPCS Level II code for dexmedetomidine, oral, 1 mcg. It belongs to the Drugs Administered Other Than Oral Method section. Medicare does not pay it: see the coverage note below before you bill it.
Medicare coverage: Not payable by Medicare
Medicare does not pay this code. It may still be valid for another payer, but a Medicare claim carrying it will not be reimbursed.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q4-Oct. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusN
Non-covered service. Medicare does not cover it.
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 J1105 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
- 360 units MAI 3: Date of Service Edit: Clinical · Prescribing Information
- outpatient
- 360 units MAI 3: Date of Service Edit: Clinical · Prescribing Information
- DME supplier
- 360 units MAI 3: Date of Service Edit: Clinical · CMS Policy
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 2026Q4.
The CMS record for J1105
- Long descriptor
- Dexmedetomidine, oral, 1 mcg
- Short descriptor
- Dexmedetomidine film, 1 mcg
- Added
- January 1, 2024
- 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 J1105
HCPCS has no hierarchy: related items simply sit next to each other in the numbering. If J1105 is not quite right, the correct code is very often within a few positions of it.
- J1073Testosterone pellet, implant, 75 mg
- J1080Injection, testosterone cypionate, 1 cc, 200 mgterminated
- J1094Injection, dexamethasone acetate, 1 mgterminated
- J1095Injection, dexamethasone 9 percent, intraocular, 1 microgram
- J1096Dexamethasone, lacrimal ophthalmic insert, 0.1 mg
- J1097Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml
- J1098Articaine ophthalmic, 8% solution, 0.4 ml
- J1100Injection, dexamethasone sodium phosphate, 1 mg
- J1110Injection, dihydroergotamine mesylate, per 1 mg
- J1120Injection, acetazolamide sodium, up to 500 mg
- J1130Injection, diclofenac sodium, 0.5 mg
- J1160Injection, digoxin, up to 0.5 mg
- J1162Injection, digoxin immune fab (ovine), per vial
- J1163Injection, diltiazem hydrochloride, 0.5 mg
- J1164Injection, diltiazem hydrochloride in 0.72% sodium chloride, 0.5 mg
- J1165Injection, phenytoin sodium, per 50 mg