J7601: Ensifentrine, inhalation suspension, fda approved final product, non-compounded, administered through dme, unit dose form, 3 mg
J7601 is a HCPCS Level II code for ensifentrine, inhalation suspension, fda approved final product, non-compounded, administered through dme, unit dose form, 3 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 2026Q4-Oct. 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 J7601 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
- 2 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 2026Q4.
The CMS record for J7601
- Long descriptor
- Ensifentrine, inhalation suspension, fda approved final product, non-compounded, administered through dme, unit dose form, 3 mg
- Short descriptor
- Ensifentrine inh 3 mg
- Added
- January 1, 2025
- BETOS
- D1G
- 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 J7601
HCPCS has no hierarchy: related items simply sit next to each other in the numbering. If J7601 is not quite right, the correct code is very often within a few positions of it.
- J7525Tacrolimus, parenteral, 5 mg
- J7526Injection, mycophenolate mofetil, 5 mg
- J7527Everolimus, oral, 0.25 mg
- J7528Mycophenolate mofetil, for suspension, oral, 100 mgterminated
- J7529Mycophenolate mofetil, for suspension, oral, 5 mg
- J7530Mycophenolate mofetil (myhibbin), oral suspension, 5 mg
- J7531Prednisolone sodium phosphate, orally disintegrating tablet, 1 mg
- J7599Immunosuppressive drug, not otherwise classified
- J7604Acetylcysteine, inhalation solution, compounded product, administered through dme, unit dose form, per gram
- J7605Arformoterol, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 15 micrograms
- J7606Formoterol fumarate, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 20 micrograms
- J7607Levalbuterol, inhalation solution, compounded product, administered through dme, concentrated form, 0.5 mg
- J7608Acetylcysteine, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per gram
- J7609Albuterol, inhalation solution, compounded product, administered through dme, unit dose, 1 mg
- J7610Albuterol, inhalation solution, compounded product, administered through dme, concentrated form, 1 mg
- J7611Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg