HCPCS Level II › J codes J1990 Chlordiazepoxide injectionInjection, chlordiazepoxide hcl, up to 100 mg
Medicare coverage: Special coverage instructions apply Status: active (October 2026 file) Medically Unlikely Edits (effective October 1, 2026) Practitioner: max 0 units per day (clinical), rationale: Drug discontinued Outpatient hospital: max 0 units per day (clinical), rationale: Drug discontinued DME supplier: max 0 units per day (clinical), rationale: Drug discontinued Medicare pricing for J1990 Physician Fee Schedule (CY 2026, RVU26D) Status E: excluded from the PFS by regulation.
Payer policies and prior authorization for J1990 0 of 1 payer prior-auth lists that name J1990 require prior authorization or set conditions.
Payer coverage policies that name J1990 J1990 appears in 1 coverage policy from Aetna.
Payer Policy Role in policy Reviewed 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: $21.05 (medical), effective Jan 1, 2006 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $22.10 (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.