HCPCS Level II › J codes J0620 Calcium glycer & lact/10 mlInjection, calcium glycerophosphate and calcium lactate, per 10 ml
Medicare coverage: Special coverage instructions apply Status: active (October 2026 file) Medically Unlikely Edits (effective October 1, 2026) Practitioner: max 1 units per day (clinical), rationale: Prescribing Information Outpatient hospital: max 1 units per day (clinical), rationale: Prescribing Information DME supplier: max 0 units per day (clinical), rationale: CMS Policy Medicare pricing for J0620 Physician Fee Schedule (CY 2026, RVU26D) Status E: excluded from the PFS by regulation.
Payer policies and prior authorization for J0620 Payer coverage policies that name J0620 J0620 appears in 2 coverage policies from Aetna.
Payer Policy Role in policy Reviewed Document Aetna Autism Spectrum Disorders (0648) not covered Oct 2, 2025 payer document Aetna Injectable Medications (0020) listed, no stance (range J0278-J2543) Mar 5, 2026 payer document
Medicaid fee-for-service KY: $0.00 (asc), effective Jan 1, 2026 VA: $8.95 (medical), effective Apr 1, 2005 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $8.96 (professional_administered_drugs), effective Jul 1, 2026 WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), effective Apr 1, 2026 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.