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HCPCS J1250 · Level II · Part B drug

HCPCS J1250: Injection, dobutamine hydrochloride, per 250 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 J1250

Billing unit
250 MG
Inj dobutamine hcl/250 mg
ASP payment limit
$8.875
October 2026; +15.4% vs July 2026
Practitioner MUE
2
MAI 3
OPPS status
SI N
NCCI exposure
no PTP pairs
Coverage articles
1
4 states

TL;DR

HCPCS J1250 is the Level II code for Injection, dobutamine hydrochloride, per 250 mg, billed per 250 MG. The Medicare Part B ASP payment limit for October 2026 is $8.875 per billing unit, up 15.4% from July 2026. The practitioner MUE allows up to 2 units per date of service (MAI 3). Under OPPS it carries status indicator N. J1250 is billed in units of 250 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 17 NDCs to it, sold as Dobutamine HCl, Dobutamine HCl In Dextrose by Hikma Pharmaceuticals USA Inc., Baxter Healthcare Corporation, Hospira, Inc.. 1 Medicare coverage article lists the code across 4 states, including .

Medicare Part B payment limit (ASP)

CMS sets the Part B payment limit for J1250 at $8.875 per 250 MG for October 2026, derived from manufacturer average sales price plus 6%, compared with $7.691 in July 2026. Beneficiary coinsurance is 20%.

ASP payment limits for J1250
QuarterPayment limitPerCoinsurance
October 2026$8.875250 MG20%
July 2026$7.691250 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 17 NDCs from 7 labelers to J1250. Report the NDC in the claim's drug segment and bill the number of J1250 units that equals the quantity administered divided by 250 MG; the last column gives units per full package.

NDCs that crosswalk to J1250
NDCDrug nameLabelerPackage sizeBilling units / package
00143-9141-10Dobutamine HClHikma Pharmaceuticals USA Inc.20 × 1010
00338-1073-02Dobutamine HClBaxter Healthcare Corporation250 × 1818
00338-1075-02Dobutamine HClBaxter Healthcare Corporation250 × 1836
00338-1077-02Dobutamine HClBaxter Healthcare Corporation250 × 1872
00409-0025-10Dobutamine HCl In DextroseHospira, Inc.250 × 1212
00409-0151-10Dobutamine HCl In DextroseHospira, Inc.250 × 1224
00409-1100-10Dobutamine HCl In DextroseHospira, Inc.250 × 1248
00409-2344-01Dobutamine HClPfizer Inc20 × 11
00409-2344-02Dobutamine HClPfizer Inc20 × 1010
00409-2344-88Dobutamine HClPfizer Inc20 × 1010
50090-4562-00Dobutamine HClA-S Medication Solutions250 × 14
51662-1330-01Dobutamine HClHF Acquisition Co. LLC, DBA HealthFirst250 × 12
51662-1337-01Dobutamine HClHF Acquisition Co. LLC, DBA HealthFirst20 × 11
51662-1337-03Dobutamine HClHF Acquisition Co. LLC, DBA HealthFirst20 × 1010
51662-1566-01Dobutamine HClHF Acquisition Co. LLC, DBA HealthFirst250 × 11
70436-0203-80Dobutamine HClSlate Run Pharmaceuticals20 × 11
70436-0203-82Dobutamine HClSlate Run Pharmaceuticals20 × 1010

Medically Unlikely Edits (MUE)

CMS publishes 3 MUE values for J1250. For practitioners the limit is 2 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 J1250 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services23 Date of Service Edit: ClinicalClinical: Data
Facility outpatient hospital43 Date of Service Edit: ClinicalClinical: Data
DME supplier603 Date of Service Edit: ClinicalClinical: Data

NCCI edits and add-on relationships

No active practitioner PTP pair lists J1250 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.

J1250 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 J1250 in their HCPCS tables, covering 4 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 J1250
ArticleTitleContractor(s)StatesRelated LCD
Billing and Coding: Cardiac Blood Pool Imaging (Multiple Gated Acquisition Scanning- MUGA, Ventriculography) When Performed in Conjunction with Cardiotoxic ChemotherapyPalmetto GBANC SC VA WVL33457

Hospital outpatient (OPPS) status

In the July 2026 OPPS Addendum B, J1250 carries status indicator N. Status N means payment is packaged into the associated procedure and no separate OPPS payment is made.

Common denials for J1250 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 J1250 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 J1250

What does HCPCS code J1250 describe?

J1250 is defined by CMS as "Injection, dobutamine hydrochloride, per 250 mg". Each billing unit represents 250 MG, so the units reported on the claim must equal the dose administered divided by that unit.

What is the Medicare reimbursement for J1250 in October 2026?

The ASP-based payment limit is $8.875 per 250 MG, with 20% beneficiary coinsurance. Medicare Administrative Contractors apply this limit; commercial payers use their own fee schedules. The July 2026 limit was $7.691.

How many units of J1250 can be billed per day?

The practitioner Medically Unlikely Edit is 2 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 J1250?

The October 2026 ASP crosswalk lists 17 NDCs from 7 labelers: Dobutamine HCl (Hikma Pharmaceuticals USA Inc.); Dobutamine HCl (Baxter Healthcare Corporation); Dobutamine HCl In Dextrose (Hospira, Inc.); Dobutamine HCl (Pfizer Inc). For example NDC 00143-9141-10 is a 20 package equal to 10 billing units. The crosswalk's billing-units-per-package figure converts each package into J1250 units.

Does J1250 have NCCI bundling edits?

No active practitioner PTP pairs list J1250 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 J1250?

1 current Billing and Coding Article in the Medicare Coverage Database list J1250, covering 4 states: (Billing and Coding: Cardiac Blood Pool Imaging (Multiple Gated Acquisition Scanning- MUGA, Ventriculography) When Performed in Conjunction with Cardiotoxic Chemotherapy).

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.