HCPCS Level II › J codes J7304 Contraceptive hormone patchContraceptive supply, hormone containing patch, each
Medicare coverage: Non-covered by statute Status: active (October 2026 file) Medically Unlikely Edits (effective October 1, 2026) Practitioner: max 0 units per day (clinical), rationale: CMS Policy Outpatient hospital: max 0 units per day (clinical), rationale: CMS Policy Medicare pricing for J7304 Physician Fee Schedule (CY 2026, RVU26D) Status N: non-covered service.
Payer policies and prior authorization for J7304 Medicaid fee-for-service IL: $33.59 (practitioner), effective Apr 1, 2026 IN: $36.34 (professional, Advanced Practice Nurse (85%), non-facility), effective Jul 1, 2018 KS: $30.54 (default, Exempt Physician), effective Apr 1, 2025 KY: $7.64 (preventive), effective Jan 1, 2026 OK: $0.00 (physician, non-facility), effective Jul 1, 2026 TX: $43.27 (family_planning_clinic, Family Planning Clinic, non-facility), effective Mar 1, 2019 VA: $120.33 (medical), effective Jan 3, 2013 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $32.38 (family_planning, non-facility), 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.