J1574 — Injection, ganciclovir sodium (exela), not therapeutically equivalent to j1570, 500 mg
J1574 is a HCPCS Level II code for injection, ganciclovir sodium (exela), not therapeutically equivalent to j1570, 500 mg. It belongs to the Drugs Administered Other Than Oral Method section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Special coverage instructions apply
There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
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 J1574
- Long descriptor
- Injection, ganciclovir sodium (exela), not therapeutically equivalent to j1570, 500 mg
- Short descriptor
- Inj, ganciclovir (exela)
- Added
- January 1, 2023
- 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 J1574
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If J1574 is not quite right, the correct code is very often within a few positions of it.
- J1562Injection, immune globulin (vivaglobin), 100 mgterminated
- J1566Injection, immune globulin, intravenous, lyophilized (e.g., powder), not otherwise specified, 500 mg
- J1568Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mg
- J1569Injection, immune globulin, (gammagard liquid/gammagard liquid erc), 500 mg
- J1570Injection, ganciclovir sodium, 500 mg
- J1571Injection, hepatitis b immune globulin (hepagam b), intramuscular, 0.5 ml
- J1572Injection, immune globulin, (flebogamma/flebogamma dif), intravenous, non-lyophilized (e.g., liquid), 500 mg
- J1573Injection, hepatitis b immune globulin (hepagam b), intravenous, 0.5 ml
- J1575Injection, immune globulin/hyaluronidase, (hyqvia), 100 mg immuneglobulin
- J1576Injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mg
- J1577Injection, immune globulin (qivigy), 100 mg
- J1580Injection, garamycin, gentamicin, up to 80 mg
- J1590Injection, gatifloxacin, 10 mgterminated
- J1595Injection, glatiramer acetate, 20 mg
- J1596Injection, glycopyrrolate, 0.1 mg
- J1597Injection, glycopyrrolate (glyrx-pf), 0.1 mg
Questions about J1574
What is HCPCS code J1574?
J1574 is a HCPCS Level II code for injection, ganciclovir sodium (exela), not therapeutically equivalent to j1570, 500 mg. It sits in the Drugs Administered Other Than Oral Method section.
Does Medicare cover J1574?
The CMS HCPCS file marks J1574 as "Special coverage instructions apply". There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
How is J1574 paid under the physician fee schedule?
J1574 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).