J0735 Clonidine hydrochlorideInjection, clonidine hydrochloride, 1 mg
J0735 payment limit: $14.192 per 1 MG, effective October 1, 2026 through December 31, 2026, based on 2Q26 ASP data. Coinsurance 20%.
00143-9723-01 Clonidine Hydrochloride Injection, Hikma Pharmaceuticals USA Inc.: 5 billing units per package (10 mL in 1 VIAL, SINGLE-USE)00143-9724-01 Clonidine Hydrochloride Injection, Hikma Pharmaceuticals USA Inc.: 1 billing unit per package (10 mL in 1 VIAL, SINGLE-USE)39822-2000-01 Clonidine Hydrochloride Injection, XGen Pharmaceuticals DJB, Inc.: 1 billing unit per package (10 mL in 1 VIAL, SINGLE-DOSE)67457-0218-10 Duraclon, Mylan Institutional LLC: 1 billing unit per package (1 VIAL in 1 CARTON / 10 mL in 1 VIAL)Status E: excluded from the PFS by regulation.
J0735 appears in 7 coverage policies from Aetna.
| 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 | Enuresis (0431) | not covered | Jul 1, 2026 | payer document |
| Aetna | Infusion Pumps (0161) | covered if criteria are met | Mar 31, 2026 | payer document |
| Aetna | Infusion Pumps (0161) Disposable insulin delivery systems [e.g., V-G™] | not covered | Mar 31, 2026 | payer document |
| Aetna | Injectable Medications (0020) | listed, no stance (range J0278-J2543) | Mar 5, 2026 | payer document |
| Aetna | Myalgic Encephalomyelitis - Chronic Fatigue Syndrome (ME/CSF) (0369) Anakinra, nutraceutical interventions, probiotics, Intravenous glutathione | not covered | May 20, 2026 | payer document |
| Aetna | Parkinson's Disease (0307) | listed, no stance | Feb 24, 2026 | payer document |
| Aetna | Tourette's Syndrome (0480) Tetrabenazine | covered if criteria are met | Jul 24, 2026 | 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.