J2020 Linezolid injectionInjection, linezolid, 200 mg
J2020 payment limit: $2.431 per 200 MG, effective October 1, 2026 through December 31, 2026, based on 2Q26 ASP data. Coinsurance 20%.
57664-0683-57 Linezolid, Caraco Pharmaceutical Laboratories LTD.: 30 billing units per package (10 BAG in 1 BOX / 300 mL in 1 BAG)55150-0242-51 Linezolid, Eugia US LLC: 30 billing units per package (10 POUCH in 1 CARTON / 1 BAG in 1 POUCH / 300 mL in 1 BAG)63323-0713-13 Linezolid, FreseniUS Kabi USA, LLC: 30 billing units per package (10 BAG in 1 CASE / 300 mL in 1 BAG)00143-9534-10 Linezolid, Hikma Pharmaceuticals USA Inc.: 30 billing units per package (10 POUCH in 1 BOX / 1 BAG in 1 POUCH / 300 mL in 1 BAG)66794-0219-43 Linezolid, Piramal Critical Care Inc: 30 billing units per package (10 BAG in 1 CARTON / 300 mL in 1 BAG)66794-0236-43 Linezolid, Piramal Critical Care Inc: 30 billing units per package (10 BAG in 1 CARTON / 300 mL in 1 BAG)25021-0169-87 Linezolid, Sagent Pharmaceuticals: 30 billing units per package00781-3433-95 Linezolid, Sandoz Inc.: 30 billing units per package (10 BAG in 1 CARTON / 300 mL in 1 BAG)00009-5137-04 Zyvox, Pfizer Inc: 10 billing units per package00009-5140-04 Zyvox, Pfizer Inc: 30 billing units per package (10 BAG in 1 BOX / 300 mL in 1 BAG)00009-7807-02 Zyvox, Pfizer Inc: 30 billing units per package (10 BAG in 1 BOX / 300 mL in 1 BAG)Status E: excluded from the PFS by regulation.
12 of 12 payer prior-auth lists that name J2020 require prior authorization or set conditions: Molina Complete Care (Virginia), Molina Healthcare of Arizona, Molina Healthcare of California, Molina Healthcare of Florida, Molina Healthcare of Idaho, Molina Healthcare of Michigan, Molina Healthcare of New Mexico, Molina Healthcare of South Carolina, Molina Healthcare of Utah, Molina Healthcare of Washington, Molina Healthcare of Wisconsin, Molina Healthcare, Inc. (national grid).
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| Molina Complete Care (Virginia) | Medicare-only PA matrix for D-SNP | VA | prior auth required | Jan 1, 2022 | Medicare Prior Auth (PA) Code Matrix (Virginia), effective Q1 2022 | |
| Molina Healthcare of Arizona | Medicare-only PA matrix for D-SNP | AZ | prior auth required | Jan 1, 2022 | Medicare Prior Auth (PA) Code Matrix (Arizona), effective Q1 2022 | |
| Molina Healthcare of California | Medicare Advantage | CA | prior auth required | Jul 1, 2021 | Medicare Prior Auth (PA) Code Matrix (California), effective Q3 2021 | |
| Molina Healthcare of Florida | Medicare Advantage | FL | prior auth required | Apr 1, 2021 | Medicare Prior Auth (PA) Code Matrix (Florida), effective Q2 2021 | |
| Molina Healthcare of Idaho | Medicare Advantage | ID | prior auth required | Apr 1, 2021 | Medicare Prior Auth (PA) Code Matrix (Idaho), effective Q2 2021 | |
| Molina Healthcare of Michigan | Exchange | MI | prior auth required | Jul 1, 2021 | Molina Healthcare of Michigan PA Matrix, effective 7/1/2021 | |
| Molina Healthcare of New Mexico | Medicare Advantage | NM | prior auth required | Jan 1, 2021 | Medicare Prior Auth (PA) Code Matrix (New Mexico), effective Q1 2021 | |
| Molina Healthcare of South Carolina | Medicare Advantage | SC | prior auth required | Apr 1, 2021 | Medicare Prior Auth (PA) Code Matrix (South Carolina), effective Q2 2021 | |
| Molina Healthcare of Utah | Medicare Advantage | UT | prior auth required | Apr 1, 2021 | Medicare Prior Auth (PA) Code Matrix (Utah), effective Q2 2021 | |
| Molina Healthcare of Washington | Medicare Advantage | WA | prior auth required | Apr 1, 2021 | Medicare Prior Auth (PA) Code Matrix (Washington), effective Q2 2021 | |
| Molina Healthcare of Wisconsin | Medicare Advantage | WI | prior auth required | Oct 1, 2021 | Medicare Prior Auth (PA) Code Matrix (Wisconsin), effective Q4 2021 | |
| Molina Healthcare, Inc. (national grid) | Molina national (MHI) Medicare grid | All | prior auth required | Oct 1, 2021 | Medicare Prior Auth (PA) Code Matrix (national), effective Q4 2021 |
J2020 appears in 3 coverage policies from Aetna, Centene.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Hyperbaric Oxygen Therapy (HBOT) (0172) | listed, no stance | Apr 21, 2026 | payer document |
| Aetna | Injectable Medications (0020) | listed, no stance (range J0278-J2543) | Mar 5, 2026 | payer document |
| Centene | Linezolid (Zyvox) (CP.PMN.27) | covered if criteria are met | Aug 1, 2026 | payer document |
Prior authorization required or conditional in WA.
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.