J7999 — Compounded drug, not otherwise classified
J7999 is a HCPCS Level II code for compounded drug, not otherwise classified. 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 J7999 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 · Clinical: Data
- outpatient
- 6 units MAI 3 — Date of Service Edit: Clinical · Clinical: Data
- DME supplier
- 0 — never payable 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 J7999
- Long descriptor
- Compounded drug, not otherwise classified
- Short descriptor
- Compounded drug, noc
- Added
- January 1, 2016
- 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 J7999
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If J7999 is not quite right, the correct code is very often within a few positions of it.
- J7681Terbutaline sulfate, inhalation solution, compounded product, administered through dme, unit dose form, per milligram
- J7682Tobramycin, inhalation solution, fda-approved final product, non-compounded, unit dose form, administered through dme, per 300 milligrams
- J7683Triamcinolone, inhalation solution, compounded product, administered through dme, concentrated form, per milligram
- J7684Triamcinolone, inhalation solution, compounded product, administered through dme, unit dose form, per milligram
- J7685Tobramycin, inhalation solution, compounded product, administered through dme, unit dose form, per 300 milligrams
- J7686Treprostinil, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, 1.74 mg
- J7699Noc drugs, inhalation solution administered through dme
- J7799Noc drugs, other than inhalation drugs, administered through dme
- J8498Antiemetic drug, rectal/suppository, not otherwise specified
- J8499Prescription drug, oral, non chemotherapeutic, nos
- J8501Aprepitant, oral, 5 mg
- J8502Injection, aprepitant (aponvie), 1 mg
- J8510Busulfan; oral, 2 mg
- J8515Cabergoline, oral, 0.25 mg
- J8520Capecitabine, oral, 150 mgterminated
- J8521Capecitabine, oral, 500 mgterminated
Questions about J7999
What is HCPCS code J7999?
J7999 is a HCPCS Level II code for compounded drug, not otherwise classified. It sits in the Drugs Administered Other Than Oral Method section.
Does Medicare cover J7999?
The CMS HCPCS file marks J7999 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 J7999 paid under the physician fee schedule?
J7999 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).