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HCPCS J0462 · Level II · Part B drug

HCPCS J0462: Injection, atropine sulfate, not therapeutically equivalent to j0461, 0.01 mg

Reviewed by QuickIntell RCM Editorial Team · Last reviewed

Data effective
Data currency: ASP payment limits October 2026 (effective October 1, 2026); MUE and NCCI edits 2026 Q4 (effective October 1, 2026); OPPS Addendum B July 2026 (effective July 1, 2026). Next CMS release: January 1, 2027 (ASP, MUE, NCCI and OPPS quarterly updates).

Key facts for J0462

Billing unit
0.01 MG
Atropine sulf, nte, 0.01 mg
ASP payment limit
$0.129
October 2026; +1.6% vs July 2026
Practitioner MUE
none published
CMS publishes no MUE for this code
OPPS status
SI N
NCCI exposure
no PTP pairs
Coverage articles
0
none list this code

TL;DR

HCPCS J0462 is the Level II code for Injection, atropine sulfate, not therapeutically equivalent to j0461, 0.01 mg, billed per 0.01 MG. The Medicare Part B ASP payment limit for October 2026 is $0.129 per billing unit, up 1.6% from July 2026. Under OPPS it carries status indicator N. With a 1 mg billing unit, a single administration can be hundreds of units; the unit count on the claim must equal the milligrams given, and rounding rules for partial units follow the contractor's guidance. The ASP crosswalk maps 14 NDCs to it, sold as Atropine Sulfate by Henry Schein Inc., American Regent, Inc., Hikma Pharmaceuticals USA Inc.. No current Billing and Coding Article lists J0462, so coverage follows the FDA label, compendia and any applicable NCD.

Medicare Part B payment limit (ASP)

CMS sets the Part B payment limit for J0462 at $0.129 per 0.01 MG for October 2026, derived from manufacturer average sales price plus 6%, compared with $0.127 in July 2026. Beneficiary coinsurance is 20%.

ASP payment limits for J0462
QuarterPayment limitPerCoinsurance
October 2026$0.1290.01 MG20%
July 2026$0.1270.01 MG—
Source: CMS Medicare Part B Drug Payment Limit File. Commercial and Medicaid payers set their own rates.

NDC to HCPCS billing-unit conversion

The October 2026 ASP crosswalk maps 14 NDCs from 6 labelers to J0462. Report the NDC in the claim's drug segment and bill the number of J0462 units that equals the quantity administered divided by 0.01 MG; the last column gives units per full package.

NDCs that crosswalk to J0462
NDCDrug nameLabelerPackage sizeBilling units / package
00404-9802-01Atropine SulfateHenry Schein Inc.1 × 140
00404-9989-01Atropine SulfateHenry Schein Inc.1 × 1100
00517-1001-25Atropine SulfateAmerican Regent, Inc.1 × 252500
00517-1004-25Atropine SulfateAmerican Regent, Inc.1 × 251000
00641-6274-25Atropine SulfateHikma Pharmaceuticals USA Inc.1 × 251000
00641-6275-25Atropine SulfateHikma Pharmaceuticals USA Inc.1 × 252500
16729-0525-08Atropine SulfateAccord Healthcare Inc1 × 251000
16729-0526-08Atropine SulfateAccord Healthcare Inc1 × 252500
51662-1626-01Atropine SulfateHF Acquisition Co. LLC, DBA HealthFirst1 × 1100
51662-1626-03Atropine SulfateHF Acquisition Co. LLC, DBA HealthFirst1 × 252500
51662-1627-01Atropine SulfateHF Acquisition Co. LLC, DBA HealthFirst1 × 140
51662-1627-03Atropine SulfateHF Acquisition Co. LLC, DBA HealthFirst1 × 251000
70069-0631-25Atropine SulfateSomerset Pharma, LLC1 × 251000
70069-0641-25Atropine SulfateSomerset Pharma, LLC1 × 252500

Medically Unlikely Edits (MUE)

CMS does not publish an MUE for J0462 in the 2026 Q4 tables. Some MUE values are confidential and applied without publication, so unit limits can still deny; document the dose and the units calculation on every claim.

NCCI edits and add-on relationships

No active practitioner PTP pair lists J0462 as a column-1 or column-2 code in v323r0. Drug supply codes are rarely bundled; the administration codes billed with them are where PTP edits usually apply.

J0462 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.

Medicare coverage articles

No current Billing and Coding Article lists J0462 in its HCPCS table. Coverage then follows the drug's FDA label, compendia and any National Coverage Determination; check the Medicare Coverage Database before administering off-label.

Hospital outpatient (OPPS) status

In the July 2026 OPPS Addendum B, J0462 carries status indicator N. Status N means payment is packaged into the associated procedure and no separate OPPS payment is made.

Common denials for J0462 and how to prevent them

CARC 16 · M119

NDC missing, invalid or not matched to the HCPCS code

CARC 151 · N362

units billed exceed the MUE for the date of service

CARC 50 · N115

diagnosis not covered by the applicable coverage article or LCD

How QuickIntell checks J0462 before the claim leaves

QuickCode validates the NDC-to-unit conversion against the current ASP crosswalk, checks units against every published MUE setting and flags PTP and add-on conflicts on the same claim. QuickRCM routes CARC 16, 151 and 50 denials on drug lines with the matching coverage article attached so the appeal starts with evidence.

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Frequently asked questions — HCPCS J0462

What does HCPCS code J0462 describe?

J0462 is defined by CMS as "Injection, atropine sulfate, not therapeutically equivalent to j0461, 0.01 mg". Each billing unit represents 0.01 MG, so the units reported on the claim must equal the dose administered divided by that unit.

What is the Medicare reimbursement for J0462 in October 2026?

The ASP-based payment limit is $0.129 per 0.01 MG, with 20% beneficiary coinsurance. Medicare Administrative Contractors apply this limit; commercial payers use their own fee schedules. The July 2026 limit was $0.127.

Which NDCs map to J0462?

The October 2026 ASP crosswalk lists 14 NDCs from 6 labelers: Atropine Sulfate (Henry Schein Inc.); Atropine Sulfate (American Regent, Inc.); Atropine Sulfate (Hikma Pharmaceuticals USA Inc.); Atropine Sulfate (Accord Healthcare Inc). For example NDC 00404-9802-01 is a 1 package equal to 40 billing units. The crosswalk's billing-units-per-package figure converts each package into J0462 units.

Does J0462 have NCCI bundling edits?

No active practitioner PTP pairs list J0462 as a column-1 or column-2 code in the v323r0 release. Unit limits (MUE) and medical-necessity coverage rules still apply.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-02. Verify against the primary file before billing or contracting decisions.

Disclaimer

This page is an operational reference compiled from CMS publications: the Medicare Part B drug payment limit and NDC crosswalk files, NCCI MUE and add-on edit tables, aggregate PTP statistics, OPPS Addendum B and the Medicare Coverage Database. Payment limits are Medicare national amounts; commercial and Medicaid payers differ. CPT codes are shown as numbers only; CPT descriptors are copyright AMA. Nothing here is legal, clinical or billing advice.