HCPCS Level II › J codes J2725 Inj protirelin per 250 mcgInjection, protirelin, per 250 mcg
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 J2725 Physician Fee Schedule (CY 2026, RVU26D) Status E: excluded from the PFS by regulation.
Payer policies and prior authorization for J2725 Payer coverage policies that name J2725 J2725 appears in 1 coverage policy from Aetna.
Payer Policy Role in policy Reviewed Document Aetna Injectable Medications (0020) listed, no stance (range J2550-J3520) Mar 5, 2026 payer document
Medicaid fee-for-service CO: $24.08 (health_first_colorado), effective Jul 1, 2026 KY: $0.00 (asc), effective Jan 1, 2026 VA: $21.78 (medical), effective Jul 1, 2005 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $22.08 (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.