J7613 — Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg
J7613 is a HCPCS Level II code for albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 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
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 J7613 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
- 10 units MAI 3 — Date of Service Edit: Clinical · Prescribing Information
- outpatient
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
- DME supplier
- 1395 units MAI 3 — Date of Service Edit: Clinical · Published Contractor 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 J7613
- Long descriptor
- Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg
- Short descriptor
- Albuterol non-comp unit
- Added
- January 1, 2005
- BETOS
- D1G
- Pricing indicator
- 00 — Not priced by Part B
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.
Service not separately priced by Part B — not covered, bundled into another service, or used by Part A only.
Codes adjacent to J7613
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If J7613 is not quite right, the correct code is very often within a few positions of it.
- 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
- J7612Levalbuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 0.5 mg
- J7614Levalbuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 0.5 mg
- J7615Levalbuterol, inhalation solution, compounded product, administered through dme, unit dose, 0.5 mg
- J7620Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme
- J7622Beclomethasone, inhalation solution, compounded product, administered through dme, unit dose form, per milligram
- J7624Betamethasone, inhalation solution, compounded product, administered through dme, unit dose form, per milligram
- J7626Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg
- J7627Budesonide, inhalation solution, compounded product, administered through dme, unit dose form, up to 0.5 mg
- J7628Bitolterol mesylate, inhalation solution, compounded product, administered through dme, concentrated form, per milligram
Questions about J7613
What is HCPCS code J7613?
J7613 is a HCPCS Level II code for albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg. It sits in the Drugs Administered Other Than Oral Method section.
Does Medicare cover J7613?
The CMS HCPCS file marks J7613 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 J7613 paid under the physician fee schedule?
J7613 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).