`J7508` Tacrol astagraf ex rel oral

Tacrolimus, extended release, (astagraf xl), oral, 0.1 mg

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: CMS Policy
Outpatient hospital: max 300 units per day (clinical), rationale: Prescribing Information
DME supplier: max 9000 units per day (clinical), rationale: Prescribing Information

Medicare pricing for J7508

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

J7508 payment limit: $0.604 per 0.1 MG, effective October 1, 2026 through December 31, 2026, based on 2Q26 ASP data. Coinsurance 20%.

NDCs that bill under J7508 (CMS ASP NDC-HCPCS crosswalk, October 2026)

00469-0647-73 Astagraf XL, Astellas Pharma US, Inc.: 150 billing units per package (1 BOTTLE in 1 CARTON / 30 CAPSULE, COATED, EXTENDED RELEASE in 1 BOTTLE)
00469-0677-73 Astagraf XL, Astellas Pharma US, Inc.: 300 billing units per package (1 BOTTLE in 1 CARTON / 30 CAPSULE, COATED, EXTENDED RELEASE in 1 BOTTLE)
00469-0687-73 Astagraf XL, Astellas Pharma US, Inc.: 1500 billing units per package (1 BOTTLE in 1 CARTON / 30 CAPSULE, COATED, EXTENDED RELEASE in 1 BOTTLE)

Physician Fee Schedule (CY 2026, RVU26D)

Status E: excluded from the PFS by regulation.

Payer policies and prior authorization for J7508

0 of 1 payer prior-auth lists that name J7508 require prior authorization or set conditions.

Payer coverage policies that name J7508

J7508 appears in 9 coverage policies from Aetna.

Payer	Policy	Role in policy	Reviewed	Document
Aetna	Dry Eyes (0457)	not covered	Jul 29, 2026	payer document
Aetna	Eculizumab (0807)	listed, no stance	Aug 11, 2026	payer document
Aetna	Erectile Dysfunction and Peyronie's Disease (0007)	not covered	Jul 29, 2026	payer document
Aetna	Fetal Echocardiography and Magnetocardiography (0106)	listed, no stance	Mar 26, 2026	payer document
Aetna	Inebilizumab-cdon (Uplizna) (0975)	listed, no stance	Aug 11, 2026	payer document
Aetna	Nipocalimab-aahu (Imaavy) (1083)	listed, no stance	Aug 11, 2026	payer document
Aetna	Ravulizumab-cwvz (Ultomiris) (0946)	listed, no stance	Aug 11, 2026	payer document
Aetna	Rituximab (0314)	listed, no stance	Sep 15, 2026	payer document
Aetna	Rozanolixizumab-noli (Rystiggo) (1035)	listed, no stance	Aug 11, 2026	payer document

Recent prior-auth changes

Apr 1, 2025: PA removed, UnitedHealthcare
Mar 1, 2025: PA added, UnitedHealthcare
Jan 1, 2025: PA removed, UnitedHealthcare

Medicaid fee-for-service

AZ: $0.60 (outpatient_hospital), effective Jul 1, 2026
IN: $0.53 (professional, Advanced Practice Nurse (85%), non-facility), effective Apr 1, 2026
KY: $0.00 (asc), effective Jan 1, 2026
MA: $0.48 (dme_rates), effective Mar 1, 2026
MS: $0.59 (comprehensive), effective Jul 1, 2026
NE: $0.60 (injectables), effective Jul 1, 2026
OH: $0.60 (provider_administered_drugs), effective Jul 1, 2026
OK: $0.60 (physician, non-facility), effective Jul 1, 2026
VA: $0.60 (medical), effective Jul 1, 2026
VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
WA: $0.60 (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.

J7508 Tacrol astagraf ex rel oral