`J2290` Inj, nafcillin sodium, 20 mg

Injection, nafcillin sodium, 20 mg

Medicare coverage: Special coverage instructions apply
Status: active (October 2026 file)

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 300 units per day (clinical), rationale: Prescribing Information

Medicare pricing for J2290

Medicare Part B drug payment limit (ASP, October 2026)

J2290 payment limit: $0.047 per 20 MG, effective October 1, 2026 through December 31, 2026, based on 2Q26 ASP data. Coinsurance 20%.

NDCs that bill under J2290 (CMS ASP NDC-HCPCS crosswalk, October 2026)

72485-0406-10 Nafcillin Sodium, Armas Pharmaceuticals Inc.: 1000 billing units per package (10 VIAL in 1 CARTON / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL)
70860-0116-26 Nafcillin Sodium, Athenex Pharmaceutical Division, LLC: 500 billing units per package
70860-0117-26 Nafcillin Sodium, Athenex Pharmaceutical Division, LLC: 1000 billing units per package
70860-0119-99 Nafcillin Sodium, Athenex Pharmaceutical Division, LLC: 500 billing units per package
55150-0122-15 Nafcillin Sodium, Eugia US LLC: 500 billing units per package (10 VIAL in 1 BOX / 4 mL in 1 VIAL)
55150-0123-15 Nafcillin Sodium, Eugia US LLC: 1000 billing units per package (10 VIAL in 1 BOX / 8 mL in 1 VIAL)
55150-0123-16 Nafcillin Sodium, Eugia US LLC: 1000 billing units per package (10 VIAL in 1 BOX / 8 mL in 1 VIAL)
55150-0124-09 Nafcillin Sodium, Eugia US LLC: 500 billing units per package (1 VIAL, PHARMACY BULK PACKAGE in 1 BOX / 100 mL in 1 VIAL, PHARMACY BULK PACKAGE)
55150-0124-99 Nafcillin Sodium, Eugia US LLC: 500 billing units per package (1 VIAL, PHARMACY BULK PACKAGE in 1 BOX / 100 mL in 1 VIAL, PHARMACY BULK PACKAGE)
63323-0327-10 Nafcillin Sodium, FreseniUS Kabi USA, LLC: 500 billing units per package (10 VIAL in 1 CARTON / 4 mL in 1 VIAL)
63323-0328-20 Nafcillin Sodium, FreseniUS Kabi USA, LLC: 1000 billing units per package (10 VIAL in 1 CARTON / 8 mL in 1 VIAL)
63323-0328-22 Nafcillin Sodium, FreseniUS Kabi USA, LLC: 1000 billing units per package (10 VIAL in 1 CARTON / 8 mL in 1 VIAL)
63323-0330-60 Nafcillin Sodium, FreseniUS Kabi USA, LLC: 500 billing units per package (1 VIAL, PHARMACY BULK PACKAGE in 1 CARTON / 100 mL in 1 VIAL, PHARMACY BULK PACKAGE)
23155-0906-41 Nafcillin Sodium, Heritage Pharmaceuticals Inc.: 500 billing units per package (10 VIAL in 1 CARTON / 4 mL in 1 VIAL)
23155-0907-41 Nafcillin Sodium, Heritage Pharmaceuticals Inc.: 1000 billing units per package (10 VIAL in 1 CARTON / 8 mL in 1 VIAL)
72603-0453-10 Nafcillin Sodium, Northstar RxLLC: 1000 billing units per package (10 VIAL in 1 BOX / 8 mL in 1 VIAL)
72603-0567-01 Nafcillin Sodium, Northstar RxLLC: 500 billing units per package (1 VIAL, PHARMACY BULK PACKAGE in 1 CARTON / 100 mL in 1 VIAL, PHARMACY BULK PACKAGE)
25021-0139-10 Nafcillin Sodium, Sagent Pharmaceuticals: 500 billing units per package
25021-0140-10 Nafcillin Sodium, Sagent Pharmaceuticals: 1000 billing units per package
25021-0141-99 Nafcillin Sodium, Sagent Pharmaceuticals: 5000 billing units per package
25021-0198-99 Nafcillin Sodium, Sagent Pharmaceuticals: 500 billing units per package (1 VIAL in 1 CARTON / 100 mL in 1 VIAL)
44567-0221-10 Nafcillin Sodium, WG Critical Care, LLC: 500 billing units per package (10 VIAL in 1 CARTON / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL)
44567-0222-10 Nafcillin Sodium, WG Critical Care, LLC: 1000 billing units per package (10 VIAL in 1 CARTON / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL)
44567-0223-01 Nafcillin Sodium, WG Critical Care, LLC: 500 billing units per package (1 VIAL, PHARMACY BULK PACKAGE in 1 CARTON / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, PHARMACY BULK PACKAGE)
83634-0101-99 Naficillin Sodium, Avenacy Inc.: 500 billing units per package (1 BOTTLE in 1 CARTON / 100 mL in 1 BOTTLE)

Physician Fee Schedule (CY 2026, RVU26D)

Status E: excluded from the PFS by regulation.

Payer policies and prior authorization for J2290

Payer coverage policies that name J2290

J2290 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

AZ: $0.05 (outpatient_hospital), effective Apr 1, 2026
IL: $14.40 (practitioner), effective Apr 1, 2026
IN: $0.06 (professional, Advanced Practice Nurse (85%), non-facility), effective Jul 1, 2025
KS: $0.05 (default), effective Apr 1, 2026
KY: $0.00 (asc), effective Jan 1, 2026
LA: $0.05 (professional), effective Jul 1, 2026
MS: $0.05 (comprehensive), effective Jul 1, 2026
NE: $0.04 (injectables), effective Jul 1, 2026
OH: $0.06 (provider_administered_drugs), effective Apr 1, 2026
OK: $0.05 (physician, non-facility), effective Jul 1, 2026
TX: $0.25 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, non-facility), effective Jan 1, 2025
VA: $0.04 (medical), effective Apr 1, 2026
VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
WA: $0.05 (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.

J2290 Inj, nafcillin sodium, 20 mg