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 2026Q3-Jul. 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 2026Q3.
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
Questions about J1105
What is HCPCS code J1105?
J1105 is a HCPCS Level II code for dexmedetomidine, oral, 1 mcg. It sits in the Drugs Administered Other Than Oral Method section.
Does Medicare cover J1105?
The CMS HCPCS file marks J1105 as "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.
How is J1105 paid under the physician fee schedule?
J1105 carries PFS status code N. Non-covered service. Medicare does not cover it.