HCPCS Level II › J codes J2730 Pralidoxime chloride injInjection, pralidoxime chloride, up to 1 gm
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: Prescribing Information Outpatient hospital: max 2 units per day (clinical), rationale: Prescribing Information DME supplier: max 0 units per day (clinical), rationale: CMS Policy Medicare pricing for J2730 Physician Fee Schedule (CY 2026, RVU26D) Status E: excluded from the PFS by regulation.
Payer policies and prior authorization for J2730 Payer coverage policies that name J2730 J2730 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 AZ: $86.70 (outpatient_hospital), effective Oct 1, 2024 IL: $82.89 (practitioner), effective Apr 1, 2026 IN: $77.38 (professional, Advanced Practice Nurse (85%), non-facility), effective May 1, 2010 KY: $0.00 (asc), effective Jan 1, 2026 MS: $86.70 (comprehensive), effective Jul 1, 2025 NE: $92.60 (injectables), effective Jul 1, 2026 OH: $91.90 (provider_administered_drugs), effective Aug 1, 2015 OK: $91.90 (physician, non-facility), effective Jul 1, 2026 TX: $88.74 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, non-facility), effective Mar 1, 2026 VA: $91.90 (medical), effective Oct 1, 2015 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $86.70 (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.