Table of content for "Hiv prep, oral lenacapavir" (HCPCS J0752)
General information on the “J0752” code
HCPCS Code: J0752
Long Description: Oral, lenacapavir, 300 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)
Short Description: Hiv prep, oral lenacapavir
Original information is taken from J0752 page
Pricing indicators
Pricing Indicator Code 1: 57 – Other carrier priced
Multiple Pricing Indicator Code A : Not applicable as HCPCS priced under one methodology
Certification and additional reference information
Coverage
Coverage: D – Special coverage instructions apply
ASC Payment Group: YY
ASC Payment Group Effective Date: 20251001
Type of service
Berenson-Eggers Type of Service (BETOS): O1E – Other drugs
Type Of Service 1: 1 – Medical care
Type Of Service 2: P – Lump sum purchase of DME, prosthetics, orthotics
Misc information
Anesthesia Base Unit Quantity: 0
Code Added Date: 20251001
Code Effective Date: 20251001
Action Code: A – Add procedure or modifier code