`J2501` Paricalcitol

Injection, paricalcitol, 1 mcg

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

Medically Unlikely Edits (effective October 1, 2026)

Practitioner: max 2 units per day (clinical), rationale: Clinical: Data
Outpatient hospital: max 25 units per day (clinical), rationale: Clinical: Data
DME supplier: max 0 units per day (clinical), rationale: CMS Policy

Medicare pricing for J2501

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

J2501 payment limit: $0.891 per 1 MCG, effective October 1, 2026 through December 31, 2026, based on 2Q26 ASP data. Coinsurance 20%.

NDCs that bill under J2501 (CMS ASP NDC-HCPCS crosswalk, October 2026)

16729-0310-08 Paricalcitol, Accord Healthcare Inc: 50 billing units per package (25 VIAL, SINGLE-DOSE in 1 CARTON / 1 mL in 1 VIAL, SINGLE-DOSE)
16729-0311-08 Paricalcitol, Accord Healthcare Inc: 125 billing units per package (25 VIAL, SINGLE-DOSE in 1 CARTON / 1 mL in 1 VIAL, SINGLE-DOSE)
16729-0311-93 Paricalcitol, Accord Healthcare Inc: 250 billing units per package (25 VIAL, MULTI-DOSE in 1 CARTON / 2 mL in 1 VIAL, MULTI-DOSE)
00074-1658-01 Zemplar, AbbVie Inc.: 125 billing units per package (25 VIAL, SINGLE-DOSE in 1 TRAY / 1 mL in 1 VIAL, SINGLE-DOSE)
00074-1658-05 Zemplar, AbbVie Inc.: 250 billing units per package (25 VIAL, MULTI-DOSE in 1 TRAY / 2 mL in 1 VIAL, MULTI-DOSE)
00074-4637-01 Zemplar, AbbVie Inc.: 50 billing units per package (25 VIAL, SINGLE-DOSE in 1 TRAY / 1 mL in 1 VIAL, SINGLE-DOSE)

Physician Fee Schedule (CY 2026, RVU26D)

Status E: excluded from the PFS by regulation.

Payer policies and prior authorization for J2501

Payer coverage policies that name J2501

J2501 appears in 5 coverage policies from Aetna, Centene.

Payer	Policy	Role in policy	Reviewed	Document
Aetna	Burosumab-twza (Crysvita) (0932)	listed, no stance	Jan 13, 2026	payer document
Aetna	Calcitriol, Etelcalcetide, and Paricalcitol Injections (0022)	covered if criteria are met	Feb 11, 2026	payer document
Aetna	Injectable Medications (0020)	listed, no stance (range J0278-J2543)	Mar 5, 2026	payer document
Aetna	Vitiligo (0422)	not covered	Jul 16, 2026	payer document
Centene	Paricalcitol Injection (Zemplar)	covered if criteria are met	Aug 1, 2026	payer document

Medicaid fee-for-service

AZ: $0.90 (outpatient_hospital), effective Jul 1, 2026
FL: $2.00 (physician_administered_drugs), effective Jan 1, 2026
IL: $13.29 (practitioner), effective Apr 1, 2026
IN: $1.70 (professional, Advanced Practice Nurse (85%), non-facility), effective Oct 1, 2019
KS: $0.67 (default, Exempt Physician), effective Oct 1, 2026
KY: $0.00 (asc), effective Jan 1, 2026
LA: $0.90 (professional), effective Jan 1, 2025
MS: $1.02 (comprehensive), effective Jul 1, 2026
NE: $0.89 (injectables), effective Jul 1, 2026
OH: $0.90 (provider_administered_drugs), effective Jul 1, 2026
OK: $0.00 (outpatient_hospital_apc), effective Jan 1, 2026
TX: $0.97 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, non-facility), effective Sep 1, 2026
VA: $0.89 (medical), effective Jul 1, 2026
VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
WA: $0.90 (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.

J2501 Paricalcitol