Skip to main content
HCPCS J0702 · Level II · Part B drug

HCPCS J0702: Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 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 J0702

Billing unit
3 MG & 3 MG
Betamethasone acet&sod phosp
ASP payment limit
$7.175
October 2026; +0.7% vs July 2026
Practitioner MUE
18
MAI 3
OPPS status
SI N
NCCI exposure
no PTP pairs
Coverage articles
1
3 states

TL;DR

HCPCS J0702 is the Level II code for Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg, billed per 3 MG & 3 MG. The Medicare Part B ASP payment limit for October 2026 is $7.175 per billing unit, up 0.7% from July 2026. The practitioner MUE allows up to 18 units per date of service (MAI 3). Under OPPS it carries status indicator N. J0702 is billed in units of 3 MG & 3 MG; the quantity administered, the NDC package and the units on the claim must reconcile, which is the check that prevents CARC 16 and 151 returns on this line. The ASP crosswalk maps 4 NDCs to it, sold as Celestone Soluspan, Betamethasone Sodium Phosphate and Betamethasone Acetate by American Regent, Inc., Organon LLC. 1 Medicare coverage article lists the code across 3 states, including .

Medicare Part B payment limit (ASP)

CMS sets the Part B payment limit for J0702 at $7.175 per 3 MG & 3 MG for October 2026, derived from manufacturer average sales price plus 6%, compared with $7.126 in July 2026. Beneficiary coinsurance is 20%.

ASP payment limits for J0702
QuarterPayment limitPerCoinsurance
October 2026$7.1753 MG & 3 MG20%
July 2026$7.1263 MG & 3 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 4 NDCs from 2 labelers to J0702. Report the NDC in the claim's drug segment and bill the number of J0702 units that equals the quantity administered divided by 3 MG & 3 MG; the last column gives units per full package.

NDCs that crosswalk to J0702
NDCDrug nameLabelerPackage sizeBilling units / package
00517-0720-01Celestone SoluspanAmerican Regent, Inc.5 × 15
00517-0791-01Betamethasone Sodium Phosphate and Betamethasone AcetateAmerican Regent, Inc.5 × 15
00517-0799-01Betamethasone Sodium Phosphate and Betamethasone AcetateAmerican Regent, Inc.5 × 15
78206-0118-01Celestone SoluspanOrganon LLC5 × 15

Medically Unlikely Edits (MUE)

CMS publishes 3 MUE values for J0702. For practitioners the limit is 18 units per date of service with adjudication indicator 3, a date-of-service clinical edit: units above the limit deny but can be paid on appeal with documentation that the quantity was medically reasonable.

MUE values for J0702 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services183 Date of Service Edit: ClinicalClinical: Data
Facility outpatient hospital203 Date of Service Edit: ClinicalClinical: Data
DME supplier03 Date of Service Edit: ClinicalCMS Policy

NCCI edits and add-on relationships

No active practitioner PTP pair lists J0702 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.

J0702 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.

Medicare coverage articles

1 current Medicare Administrative Contractor article lists J0702 in their HCPCS tables, covering 3 states. Each article carries the covered and non-covered ICD-10 codes that medical-necessity denials (CARC 50) are adjudicated against.

Billing and Coding Articles listing J0702
ArticleTitleContractor(s)StatesRelated LCD
Billing and Coding: Trigger Point InjectionsFirst Coast Service Options, Inc.FL PR VIL33912

Hospital outpatient (OPPS) status

In the July 2026 OPPS Addendum B, J0702 carries status indicator N. Status N means payment is packaged into the associated procedure and no separate OPPS payment is made.

Common denials for J0702 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 J0702 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.

Explore QuickCodeExplore QuickRCMBook a demo

Frequently asked questions — HCPCS J0702

What does HCPCS code J0702 describe?

J0702 is defined by CMS as "Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg". Each billing unit represents 3 MG & 3 MG, so the units reported on the claim must equal the dose administered divided by that unit.

What is the Medicare reimbursement for J0702 in October 2026?

The ASP-based payment limit is $7.175 per 3 MG & 3 MG, with 20% beneficiary coinsurance. Medicare Administrative Contractors apply this limit; commercial payers use their own fee schedules. The July 2026 limit was $7.126.

How many units of J0702 can be billed per day?

The practitioner Medically Unlikely Edit is 18 units per date of service with adjudication indicator 3 (3 Date of Service Edit: Clinical). MAI 3 edits can be appealed with documentation that the units were medically reasonable. CMS cites "Clinical: Data" as the rationale.

Which NDCs map to J0702?

The October 2026 ASP crosswalk lists 4 NDCs from 2 labelers: Celestone Soluspan (American Regent, Inc.); Betamethasone Sodium Phosphate and Betamethasone Acetate (American Regent, Inc.); Celestone Soluspan (Organon LLC). For example NDC 00517-0720-01 is a 5 package equal to 5 billing units. The crosswalk's billing-units-per-package figure converts each package into J0702 units.

Does J0702 have NCCI bundling edits?

No active practitioner PTP pairs list J0702 as a column-1 or column-2 code in the v323r0 release. Unit limits (MUE) and medical-necessity coverage rules still apply.

Which Medicare coverage articles mention J0702?

1 current Billing and Coding Article in the Medicare Coverage Database list J0702, covering 3 states: (Billing and Coding: Trigger Point Injections).

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-01. 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.