J0475 Baclofen 10 mg injectionInjection, baclofen, 10 mg
J0475 payment limit: $186.996 per 10 MG, effective October 1, 2026 through December 31, 2026, based on 2Q26 ASP data. Coinsurance 20%.
67457-0564-20 Baclofen, Mylan Institutional LLC: 4 billing units per package14789-0161-05 Baclofen, Nexus Pharmaceuticals, LLC: 4 billing units per package (1 VIAL in 1 CARTON / 20 mL in 1 VIAL)25021-0678-20 Baclofen, Sagent Pharmaceuticals: 1 billing unit per package (1 VIAL in 1 CARTON / 20 mL in 1 VIAL)25021-0679-20 Baclofen, Sagent Pharmaceuticals: 4 billing units per package (1 VIAL in 1 CARTON / 20 mL in 1 VIAL)25021-0680-20 Baclofen, Sagent Pharmaceuticals: 2 billing units per package (1 VIAL in 1 CARTON / 20 mL in 1 VIAL)66794-0155-01 Gablofen, Piramal Critical Care Inc: 1 billing unit per package (20 mL in 1 SYRINGE, GLASS)66794-0155-02 Gablofen, Piramal Critical Care Inc: 1 billing unit per package (20 mL in 1 VIAL, GLASS)66794-0156-01 Gablofen, Piramal Critical Care Inc: 2 billing units per package (20 mL in 1 SYRINGE, GLASS)66794-0156-02 Gablofen, Piramal Critical Care Inc: 2 billing units per package (20 mL in 1 VIAL, GLASS)66794-0157-01 Gablofen, Piramal Critical Care Inc: 4 billing units per package (20 mL in 1 SYRINGE, GLASS)66794-0157-02 Gablofen, Piramal Critical Care Inc: 4 billing units per package (20 mL in 1 VIAL, GLASS)70121-2501-01 Lioresal, Amneal Pharmaceuticals, LLC: 1 billing unit per package (1 AMPULE in 1 BOX / 1 KIT in 1 AMPULE)70121-2502-02 Lioresal, Amneal Pharmaceuticals, LLC: 2 billing units per package (2 AMPULE in 1 BOX / 1 KIT in 1 AMPULE)70121-2503-01 Lioresal, Amneal Pharmaceuticals, LLC: 4 billing units per package (1 AMPULE in 1 BOX / 1 KIT in 1 AMPULE)70121-2504-02 Lioresal, Amneal Pharmaceuticals, LLC: 2 billing units per package (2 AMPULE in 1 BOX / 1 KIT in 1 AMPULE)70121-2505-02 Lioresal, Amneal Pharmaceuticals, LLC: 8 billing units per package (2 AMPULE in 1 BOX / 1 KIT in 1 AMPULE)Status E: excluded from the PFS by regulation.
J0475 appears in 8 coverage policies from Aetna, Centene.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Complex Regional Pain Syndrome (CRPS): Treatments (0447) Ketamine metabolite (2R,6R)-hydroxynorketamine, metformin, topical ketamine, Topical dimethyl sulfoxide, Anakinra, Sarilumab - | not covered | Jul 16, 2026 | payer document |
| Aetna | Infusion Pumps (0161) | covered if criteria are met | Mar 31, 2026 | payer document |
| Aetna | Injectable Medications (0020) | listed, no stance (range J0278-J2543) | Mar 5, 2026 | payer document |
| Aetna | Spasticity Management (0362) | listed, no stance | May 26, 2026 | payer document |
| Aetna | Spinal Cord Stimulation (0194) | listed, no stance | Sep 10, 2026 | payer document |
| Aetna | Tourette's Syndrome (0480) Ecopipam, pramipexole, VMAT-2 inhibitors (e.g., valbenazine), amphetamines, Deutetrabenazine (Austedo) | not covered | Jul 24, 2026 | payer document |
| Aetna | Trigeminal Neuralgia: Treatments (0374) | listed, no stance | Jun 29, 2026 | payer document |
| Centene | Baclofen (Fleqsuvy, Gablofen, Lioresal, Lyvispah, (CP.PHAR.149) | covered if criteria are met | Nov 1, 2025 | payer document |
From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.