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HCPCS J7507 · Level II · Part B drug

HCPCS J7507: Tacrolimus, immediate release, oral, 1 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 J7507

Billing unit
1 MG
Tacrolimus imme rel oral 1mg
ASP payment limit
$0.162
October 2026; -19.0% vs July 2026
Practitioner MUE
0
MAI 3
OPPS status
SI N
NCCI exposure
no PTP pairs
Coverage articles
0
none list this code

TL;DR

HCPCS J7507 is the Level II code for Tacrolimus, immediate release, oral, 1 mg, billed per 1 MG. The Medicare Part B ASP payment limit for October 2026 is $0.162 per billing unit, down 19.0% from July 2026. The practitioner MUE allows up to 0 units per date of service (MAI 3). Under OPPS it carries status indicator N. Oral drugs under Part B are payable only in the specific statutory categories (for example oral anticancer or antiemetic drugs with a self-administration exception), so the diagnosis and the regimen must match that category. 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 40 NDCs to it, sold as Tacrolimus, Prograf, Tacolimus by Mylan Pharmaceuticals Inc., Astellas Pharma US, Inc., Sandoz Inc.. No current Billing and Coding Article lists J7507, 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 J7507 at $0.162 per 1 MG for October 2026, derived from manufacturer average sales price plus 6%, compared with $0.20 in July 2026. Beneficiary coinsurance is 20%.

ASP payment limits for J7507
QuarterPayment limitPerCoinsurance
October 2026$0.1621 MG20%
July 2026$0.201 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 40 NDCs from 15 labelers to J7507. Report the NDC in the claim's drug segment and bill the number of J7507 units that equals the quantity administered divided by 1 MG; the last column gives units per full package.

NDCs that crosswalk to J7507
NDCDrug nameLabelerPackage sizeBilling units / package
00378-2045-01TacrolimusMylan Pharmaceuticals Inc.100 × 150
00378-2046-01TacrolimusMylan Pharmaceuticals Inc.100 × 1100
00378-2047-01TacrolimusMylan Pharmaceuticals Inc.100 × 1500
00469-0607-73PrografAstellas Pharma US, Inc.100 × 150
00469-0617-73PrografAstellas Pharma US, Inc.100 × 1100
00469-0657-73PrografAstellas Pharma US, Inc.100 × 5500
00781-2102-01TacrolimusSandoz Inc.100 × 150
00781-2103-01TacrolimusSandoz Inc.100 × 1100
00781-2104-01TacrolimusSandoz Inc.100 × 1500
00904-7097-61TacrolimusMajor Pharmaceuticals100 × 1100
16714-0098-01TacrolimusNorthstar RxLLC100 × 150
16714-0099-01TacrolimusNorthstar RxLLC100 × 1100
16714-0100-01TacrolimusNorthstar RxLLC100 × 1500
16729-0041-01TacrolimusAccord Healthcare Inc100 × 150
16729-0042-01TacrolimusAccord Healthcare Inc100 × 1100
16729-0043-01TacrolimusAccord Healthcare Inc100 × 1500
50090-5581-00TacrolimusA-S Medication Solutions90 × 190
50090-5596-00TacrolimusA-S Medication Solutions90 × 190
55111-0525-01TacrolimusDr. Reddy's Laboratories Inc.100 × 150
55111-0526-01TacrolimusDr. Reddy's Laboratories Inc.100 × 1100
55111-0527-01TacrolimusDr. Reddy's Laboratories Inc.100 × 1500
64380-0720-06TacrolimusStrides Pharma Science Limited100 × 150
64380-0721-06TacrolimusStrides Pharma Science Limited100 × 1100
64380-0722-06TacrolimusStrides Pharma Science Limited100 × 1500
67877-0278-01TacrolimusAscend Laboratories, LLC100 × 150
67877-0279-01TacrolimusAscend Laboratories, LLC100 × 1100
67877-0280-01TacrolimusAscend Laboratories, LLC100 × 1500
68084-0449-01TacrolimusAmerican Health Packaging100 × 150
68084-0450-01TacrolimusAmerican Health Packaging100 × 1100
68084-0451-01TacrolimusAmerican Health Packaging100 × 1500
68462-0685-01TacrolimusGlenmark Pharmaceuticals Inc., USA100 × 150
68462-0686-01TacrolimusGlenmark Pharmaceuticals Inc., USA100 × 1100
68462-0687-01TacrolimusGlenmark Pharmaceuticals Inc., USA100 × 1500
70377-0014-11TacrolimusBiocon Pharma Inc100 × 150
70377-0015-11TacrolimusBiocon Pharma Inc100 × 1100
70377-0016-11TacrolimusBiocon Pharma Inc100 × 1500
72572-0760-01TacrolimusCivica, Inc.100 × 150
72572-0761-01TacrolimusCivica, Inc.100 × 1100
82009-0054-01TacrolimusQuallent Pharmaceuticals100 × 1100
82009-0164-01TacolimusQuallent Pharmaceuticals100 × 150

Medically Unlikely Edits (MUE)

CMS publishes 3 MUE values for J7507. For practitioners the limit is 0 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 J7507 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services03 Date of Service Edit: ClinicalOral Medication; Not Payable
Facility outpatient hospital403 Date of Service Edit: ClinicalPrescribing Information
DME supplier12003 Date of Service Edit: ClinicalPublished Contractor Policy

NCCI edits and add-on relationships

No active practitioner PTP pair lists J7507 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.

J7507 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 J7507 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, J7507 carries status indicator N. Status N means payment is packaged into the associated procedure and no separate OPPS payment is made.

Common denials for J7507 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 J7507 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 J7507

What does HCPCS code J7507 describe?

J7507 is defined by CMS as "Tacrolimus, immediate release, oral, 1 mg". Each billing unit represents 1 MG, so the units reported on the claim must equal the dose administered divided by that unit.

What is the Medicare reimbursement for J7507 in October 2026?

The ASP-based payment limit is $0.162 per 1 MG, with 20% beneficiary coinsurance. Medicare Administrative Contractors apply this limit; commercial payers use their own fee schedules. The July 2026 limit was $0.20.

How many units of J7507 can be billed per day?

The practitioner Medically Unlikely Edit is 0 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 "Oral Medication; Not Payable" as the rationale.

Which NDCs map to J7507?

The October 2026 ASP crosswalk lists 40 NDCs from 15 labelers: Tacrolimus (Mylan Pharmaceuticals Inc.); Prograf (Astellas Pharma US, Inc.); Tacrolimus (Sandoz Inc.); Tacrolimus (Major Pharmaceuticals). For example NDC 00378-2045-01 is a 100 package equal to 50 billing units. The crosswalk's billing-units-per-package figure converts each package into J7507 units.

Does J7507 have NCCI bundling edits?

No active practitioner PTP pairs list J7507 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 2026-10-01. 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.