The provider should enter the appropriate number of units, based on the HCPCS definition and dose actually administered, not the number of units in the entire vial. This information would be reported in form locator 46 of the UB-04 claim form or in the form locator 24 G days/units on the CMS 1500 claim form.
| Sample Dose Administered | Billable Units |
|---|---|
| Patient receives 100 mg of nandrolone decanoate | Bill one unit of J2321. |
| Patient receives 1.5 g of streptomycin. | When a fraction of a unit is administered, bill for the next higher whole unit. In this case, bill two units of J3000. |
| Patient receives 200 mg of cyclophosphamide (brand names: Cytoxan, Neosar). | The provider should bill one unit of J9080 (cyclophosphamide, 200 mg). |
| Patient receives 1.5 g of cyclophosphamide. | When a fraction of a unit is administered, the provider should bill for the next higher whole unit. In this case, bill one unit of J9092 (cyclophosphamide, 2 g). |
| Patient receives 90 mg of pamidronate disodium (brand name: Aredia). | The provider should bill three units of J2430 (injection, pamidronate disodium, per 30 mg). |
| Patient receives trastuzumab (brand name: Herceptin). | The maintenance dose of trastuzumab is based on the weight of the patient at a ratio of 2 mg per 1 kg. A patient weighing 50 kg would therefore be given 100 mg. In this case, the provider should bill 10 units of J9355 (trastuzumab, 10 mg). |
Note: The administration fee is payable only if the drug is a covered benefit. Otherwise, the administration charge will be denied.
Revision History
| Date | Nature of Revision |
|---|---|
| 08/03/2026 | Migrated to new platform |