HCPCS Level II › J codes J1800 Propranolol injectionInjection, propranolol hcl, up to 1 mg
Medicare coverage: Special coverage instructions apply Status: active (October 2026 file) Medically Unlikely Edits (effective October 1, 2026) Practitioner: max 6 units per day (clinical), rationale: Clinical: Data Outpatient hospital: max 12 units per day (clinical), rationale: Clinical: Data DME supplier: max 0 units per day (clinical), rationale: CMS Policy Medicare pricing for J1800 Physician Fee Schedule (CY 2026, RVU26D) Status E: excluded from the PFS by regulation.
Payer policies and prior authorization for J1800 Payer coverage policies that name J1800 J1800 appears in 5 coverage policies from Aetna.
Payer Policy Role in policy Reviewed Document Aetna Injectable Medications (0020) listed, no stance (range J0278-J2543) Mar 5, 2026 payer document Aetna Neurogenic Bladder: Selected Treatments (0852)Instillation of neomycin-polymyxin or Oxybutynin not covered Dec 23, 2025 payer document Aetna Pharmacogenetic and Pharmacodynamic Testing (0715) listed, no stance Oct 8, 2026 payer document Aetna Temporomandibular Disorders (0028) not covered Mar 12, 2026 payer document Aetna Ventricular Assist Devices (0654) listed, no stance Sep 10, 2026 payer document
Medicaid fee-for-service AZ: $10.54 (outpatient_hospital), effective Apr 1, 2026 IL: $39.60 (practitioner), effective Apr 1, 2026 IN: $7.14 (professional, Advanced Practice Nurse (85%), non-facility), effective Oct 1, 2022 KS: $8.00 (default), effective Jan 1, 2022 KY: $0.00 (asc), effective Jan 1, 2026 MS: $10.54 (comprehensive), effective Jul 1, 2026 NE: $11.26 (injectables), effective Jul 1, 2026 OH: $3.32 (provider_administered_drugs), effective Jul 1, 2021 OK: $0.00 (outpatient_hospital_apc), effective Jan 1, 2026 TX: $8.16 (healthy_texas_women, Clinic/Group Practice, non-facility), effective Mar 1, 2023 VA: $3.31 (medical), effective Jul 1, 2021 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $8.00 (kidneycenters), 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.