J2372 Inj, biorphen, 20 micrograms

Injection, phenylephrine hydrochloride (biorphen), 20 micrograms

Medicare pricing for J2372

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

J2372 payment limit: $0.162 per 20 MCG, effective October 1, 2026 through December 31, 2026, based on 2Q26 ASP data. Coinsurance 20%.

NDCs that bill under J2372 (CMS ASP NDC-HCPCS crosswalk, October 2026)

Physician Fee Schedule (CY 2026, RVU26D)

Status E: excluded from the PFS by regulation.

Payer policies and prior authorization for J2372

Payer coverage policies that name J2372

J2372 appears in 2 coverage policies from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaInfertility (0327)covered if criteria are metJul 16, 2026payer document
AetnaInjectable Medications (0020)listed, no stance (range J0278-J2543)Mar 5, 2026payer document

Medicaid fee-for-service

  • AZ: $0.16 (outpatient_hospital), effective Jul 1, 2026
  • IN: $0.18 (professional, Advanced Practice Nurse (85%), non-facility), effective Jul 1, 2023
  • KY: $0.00 (asc), effective Jan 1, 2026
  • MS: $0.15 (comprehensive), effective Jul 1, 2026
  • NE: $0.16 (injectables), effective Jul 1, 2026
  • OH: $0.15 (provider_administered_drugs), effective Jul 1, 2026
  • OK: $0.16 (physician, non-facility), effective Jul 1, 2026
  • TX: $0.16 (healthy_texas_women, Clinic/Group Practice, non-facility), effective Sep 1, 2026
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 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.