`J7626` Budesonide non-comp unit

Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg

Medicare coverage: Carrier judgment
Status: active (October 2026 file)

Medically Unlikely Edits (effective October 1, 2026)

Practitioner: max 2 units per day (clinical), rationale: Clinical: Data
Outpatient hospital: max 0 units per day (clinical), rationale: CMS Policy
DME supplier: max 186 units per day (clinical), rationale: Published Contractor Policy

Medicare pricing for J7626

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

J7626 payment limit: $0.923 per 0.5 MG, effective October 1, 2026 through December 31, 2026, based on 2Q26 ASP data. Coinsurance 20%.

NDCs that bill under J7626 (CMS ASP NDC-HCPCS crosswalk, October 2026)

50090-1467-00 Budesonide, A-S Medication Solutions: 30 billing units per package (30 VIAL in 1 CARTON / 2 mL in 1 VIAL)
50090-6586-00 Budesonide, A-S Medication Solutions: 30 billing units per package (6 POUCH in 1 CARTON / 5 AMPULE in 1 POUCH / 2 mL in 1 AMPULE)
50090-6590-00 Budesonide, A-S Medication Solutions: 30 billing units per package (6 POUCH in 1 CARTON / 5 AMPULE in 1 POUCH / 2 mL in 1 AMPULE)
50090-7126-00 Budesonide, A-S Medication Solutions: 30 billing units per package (6 POUCH in 1 CARTON / 10 mL in 1 POUCH)
50090-7173-00 Budesonide, A-S Medication Solutions: 30 billing units per package (30 AMPULE in 1 CARTON / 2 mL in 1 AMPULE)
60687-0524-83 Budesonide, American Health Packaging: 30 billing units per package (30 POUCH in 1 CARTON / 1 AMPULE in 1 POUCH / 2 mL in 1 AMPULE)
62135-0822-84 Budesonide, Chartwell: 30 billing units per package (6 POUCH in 1 CARTON / 5 AMPULE in 1 POUCH / 2 mL in 1 AMPULE)
62135-0823-84 Budesonide, Chartwell: 30 billing units per package (6 POUCH in 1 CARTON / 5 AMPULE in 1 POUCH / 2 mL in 1 AMPULE)
69097-0318-53 Budesonide, Cipla USA, Inc.: 30 billing units per package (30 POUCH in 1 CARTON / 1 AMPULE in 1 POUCH / 2 mL in 1 AMPULE)
69097-0318-87 Budesonide, Cipla USA, Inc.: 30 billing units per package (6 POUCH in 1 CARTON / 5 AMPULE in 1 POUCH / 2 mL in 1 AMPULE)
69097-0319-53 Budesonide, Cipla USA, Inc.: 30 billing units per package (30 POUCH in 1 CARTON / 1 AMPULE in 1 POUCH / 2 mL in 1 AMPULE)
69097-0319-87 Budesonide, Cipla USA, Inc.: 30 billing units per package (6 POUCH in 1 CARTON / 5 AMPULE in 1 POUCH / 2 mL in 1 AMPULE)
69097-0321-53 Budesonide, Cipla USA, Inc.: 60 billing units per package (30 POUCH in 1 CARTON / 1 AMPULE in 1 POUCH / 2 mL in 1 AMPULE)
69097-0321-87 Budesonide, Cipla USA, Inc.: 60 billing units per package (6 POUCH in 1 CARTON / 5 AMPULE in 1 POUCH / 2 mL in 1 AMPULE)
76282-0640-38 Budesonide, Exelan Pharmaceuticals, Inc.: 30 billing units per package (6 POUCH in 1 CARTON / 5 AMPULE in 1 POUCH / 2 mL in 1 AMPULE)
76282-0641-38 Budesonide, Exelan Pharmaceuticals, Inc.: 30 billing units per package (6 POUCH in 1 CARTON / 5 AMPULE in 1 POUCH / 2 mL in 1 AMPULE)
00115-1687-74 Budesonide, Impax Laboratories, LLC: 30 billing units per package (6 POUCH in 1 CARTON / 5 VIAL in 1 POUCH / 2 mL in 1 VIAL)
00115-1689-74 Budesonide, Impax Laboratories, LLC: 30 billing units per package (6 POUCH in 1 CARTON / 5 VIAL in 1 POUCH / 2 mL in 1 VIAL)
68180-0984-30 Budesonide, Lupin Pharmaceuticals, Inc.: 30 billing units per package (6 POUCH in 1 CARTON / 5 AMPULE in 1 POUCH / 2 mL in 1 AMPULE)
00487-9601-01 Budesonide, Nephron SC, Inc.: 30 billing units per package (6 POUCH in 1 CARTON / 5 AMPULE in 1 POUCH / 2 mL in 1 AMPULE)
00487-9601-30 Budesonide, Nephron SC, Inc.: 30 billing units per package (30 POUCH in 1 CARTON / 1 AMPULE in 1 POUCH / 2 mL in 1 AMPULE)
00487-9701-01 Budesonide, Nephron SC, Inc.: 30 billing units per package (6 POUCH in 1 CARTON / 5 AMPULE in 1 POUCH / 2 mL in 1 AMPULE)
00487-9701-30 Budesonide, Nephron SC, Inc.: 30 billing units per package (30 POUCH in 1 CARTON / 1 AMPULE in 1 POUCH / 2 mL in 1 AMPULE)
16714-0020-30 Budesonide, Northstar RxLLC: 60 billing units per package
64980-0638-03 Budesonide, Rising Pharma Holdings, Inc.: 30 billing units per package (30 POUCH in 1 CARTON / 5 AMPULE in 1 POUCH / 2 mL in 1 AMPULE)
64980-0639-03 Budesonide, Rising Pharma Holdings, Inc.: 30 billing units per package (30 POUCH in 1 CARTON / 5 AMPULE in 1 POUCH / 2 mL in 1 AMPULE)
76204-0018-01 Budesonide, Ritedose Pharmaceuticals, LLC: 30 billing units per package
47335-0631-49 Budesonide, Sun Pharmaceutical Global FZE.: 30 billing units per package (6 POUCH in 1 CARTON / 5 AMPULE in 1 POUCH / 2 mL in 1 AMPULE)
47335-0632-49 Budesonide, Sun Pharmaceutical Global FZE.: 30 billing units per package (6 POUCH in 1 CARTON / 5 AMPULE in 1 POUCH / 2 mL in 1 AMPULE)
47335-0633-49 Budesonide, Sun Pharmaceutical Global FZE.: 60 billing units per package (6 POUCH in 1 CARTON / 5 AMPULE in 1 POUCH / 2 mL in 1 AMPULE)
00093-6815-55 Budesonide, Teva Pharmaceuticals USA, Inc.: 30 billing units per package (30 POUCH in 1 CARTON / 1 VIAL, SINGLE-DOSE in 1 POUCH / 2 mL in 1 VIAL, SINGLE-DOSE)
00093-6815-73 Budesonide, Teva Pharmaceuticals USA, Inc.: 30 billing units per package (6 POUCH in 1 CARTON / 5 VIAL, SINGLE-DOSE in 1 POUCH / 2 mL in 1 VIAL, SINGLE-DOSE)
00093-6816-55 Budesonide, Teva Pharmaceuticals USA, Inc.: 30 billing units per package (30 POUCH in 1 CARTON / 1 VIAL, SINGLE-DOSE in 1 POUCH / 2 mL in 1 VIAL, SINGLE-DOSE)
00093-6816-73 Budesonide, Teva Pharmaceuticals USA, Inc.: 30 billing units per package (6 POUCH in 1 CARTON / 5 VIAL, SINGLE-DOSE in 1 POUCH / 2 mL in 1 VIAL, SINGLE-DOSE)
00093-6817-73 Budesonide, Teva Pharmaceuticals USA, Inc.: 60 billing units per package (6 POUCH in 1 CARTON / 5 AMPULE in 1 POUCH / 2 mL in 1 AMPULE)
00186-1988-04 Pulmicort, AstraZeneca Pharmaceuticals LP: 30 billing units per package (6 POUCH in 1 CARTON / 5 AMPULE in 1 POUCH / 2 mL in 1 AMPULE)
00186-1989-04 Pulmicort, AstraZeneca Pharmaceuticals LP: 30 billing units per package (6 POUCH in 1 CARTON / 5 AMPULE in 1 POUCH / 2 mL in 1 AMPULE)
00186-1990-04 Pulmicort, AstraZeneca Pharmaceuticals LP: 60 billing units per package (6 POUCH in 1 CARTON / 5 AMPULE in 1 POUCH / 2 mL in 1 AMPULE)

Physician Fee Schedule (CY 2026, RVU26D)

Status E: excluded from the PFS by regulation.

Payer policies and prior authorization for J7626

Payer coverage policies that name J7626

J7626 appears in 7 coverage policies from Aetna.

Payer	Policy	Role in policy	Reviewed	Document
Aetna	Benralizumab (Fasenra) (0925)	listed, no stance	Aug 25, 2026	payer document
Aetna	Depemokimab-ulaa (Exdensur) (1098)	listed, no stance	Aug 10, 2026	payer document
Aetna	Mepolizumab (Nucala) (0897)	listed, no stance	Aug 5, 2026	payer document
Aetna	Nebulizers (0065)	covered if criteria are met	Mar 18, 2026	payer document
Aetna	Nebulizers (0065)	not covered	Mar 18, 2026	payer document
Aetna	Omalizumab (0670)	listed, no stance	Aug 21, 2026	payer document
Aetna	Reslizumab (Cinqair) (0907)	listed, no stance (range J7626-J7627)	Aug 10, 2026	payer document
Aetna	Tezepelumab-ekko (Tezspire) (1003)	listed, no stance (range J7626-J7627)	Aug 6, 2026	payer document

Medicaid fee-for-service

AZ: $1.09 (outpatient_hospital), effective Jul 1, 2026
IL: $2.19 (practitioner), effective Apr 1, 2026
IN: $5.19 (professional, Advanced Practice Nurse (85%), non-facility), effective May 1, 2010
KS: $0.69 (default, Exempt Physician), effective Oct 1, 2026
NE: $1.09 (injectables), effective Jul 1, 2026
OH: $1.09 (provider_administered_drugs), effective Jul 1, 2026
OK: $1.09 (physician, non-facility), effective Jul 1, 2026
VA: $1.09 (medical), effective Apr 1, 2026
VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
WA: $1.09 (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.

J7626 Budesonide non-comp unit