HCPCS Level II › J codes J7624 Betamethasone comp unitBetamethasone, inhalation solution, compounded product, administered through dme, unit dose form, per milligram
Medicare coverage: Carrier judgment Status: active (October 2026 file) Medically Unlikely Edits (effective October 1, 2026) Practitioner: max 0 units per day (clinical), rationale: Compounded Drug Policy Outpatient hospital: max 0 units per day (clinical), rationale: Compounded Drug Policy DME supplier: max 0 units per day (clinical), rationale: Compounded Drug Policy Medicare pricing for J7624 Physician Fee Schedule (CY 2026, RVU26D) Status E: excluded from the PFS by regulation.
Payer policies and prior authorization for J7624 Payer coverage policies that name J7624 J7624 appears in 1 coverage policy from Aetna.
Payer Policy Role in policy Reviewed Document Aetna Benralizumab (Fasenra) (0925) listed, no stance Aug 25, 2026 payer document
Medicaid fee-for-service Prior authorization required or conditional in IN.
KS: $0.54 (default, Exempt Physician), effective Jun 1, 2002 OH: $1.21 (provider_administered_drugs), effective Apr 1, 2006 VA: $0.73 (medical), effective Jul 1, 2005 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $0.73 (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.