HCPCS Level II › J codes J1953 Levetiracetam injectionInjection, levetiracetam, 10 mg
Medicare coverage: Carrier judgment Status: terminated 20260930 Medically Unlikely Edits (effective October 1, 2026) Practitioner: max 300 units per day (clinical), rationale: Prescribing Information Outpatient hospital: max 300 units per day (clinical), rationale: Prescribing Information DME supplier: max 0 units per day (clinical), rationale: CMS Policy Medicare pricing for J1953 Physician Fee Schedule (CY 2026, RVU26D) Status I: not valid for Medicare (Medicare uses another code).
Payer policies and prior authorization for J1953 0 of 1 payer prior-auth lists that name J1953 require prior authorization or set conditions.
Payer coverage policies that name J1953 J1953 appears in 6 coverage policies from Aetna.
Payer Policy Role in policy Reviewed Document Aetna Alzheimer's Disease: Experimental, Investigational, or Unproven Treatments (0788) not covered Nov 19, 2025 payer document Aetna Eagle's and Ernest Syndrome (0400) listed, no stance Jun 30, 2026 payer document Aetna Epilepsy Surgery (0394) listed, no stance Jun 23, 2026 payer document Aetna Injectable Medications (0020) listed, no stance (range J0278-J2543) Mar 5, 2026 payer document Aetna Ultrasound for Pregnancy (0199) listed, no stance Mar 24, 2026 payer document Aetna Vasectomy Procedures and Chronic Scrotal Content Pain (0027) listed, no stance Jan 27, 2026 payer document
Recent prior-auth changes Apr 1, 2025: PA removed, UnitedHealthcare Mar 1, 2025: PA added, UnitedHealthcare Jan 1, 2025: PA removed, UnitedHealthcare Medicaid fee-for-service AZ: $0.03 (outpatient_hospital), effective Apr 1, 2026 FL: $300.00 (physician_administered_drugs), effective Jan 1, 2026 IL: $0.03 (practitioner), effective Apr 1, 2026 IN: $0.03 (professional, Advanced Practice Nurse (85%), non-facility), effective Jul 1, 2020 KS: $0.03 (default), effective Apr 1, 2026 KY: $0.00 (asc), effective Jan 1, 2026 MS: $0.03 (comprehensive), effective Jul 1, 2026 NE: $0.03 (injectables), effective Jul 1, 2026 OH: $0.04 (provider_administered_drugs), effective Apr 1, 2026 OK: $0.03 (physician, non-facility), effective Jul 1, 2026 TX: $0.04 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, non-facility), effective Sep 1, 2026 VA: $0.03 (medical), effective Jan 1, 2026 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $0.03 (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.