J7638 Dexamethasone comp unit

Dexamethasone, inhalation solution, compounded product, administered through dme, unit dose form, per milligram

Medically Unlikely Edits (effective October 1, 2026)

Medicare pricing for J7638

Physician Fee Schedule (CY 2026, RVU26D)

Status E: excluded from the PFS by regulation.

Payer policies and prior authorization for J7638

Payer coverage policies that name J7638

J7638 appears in 12 coverage policies from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaBelimumab (Benlysta) (0818)listed, no stanceJun 10, 2026payer document
AetnaBenralizumab (Fasenra) (0925)listed, no stanceAug 25, 2026payer document
AetnaDepemokimab-ulaa (Exdensur) (1098)listed, no stance (range J7637-J7638)Aug 10, 2026payer document
AetnaEmapalumab-lzsg (Gamifant) (0948)listed, no stanceDec 8, 2025payer document
AetnaHypertrophic Scars and Keloids (0389)covered if criteria are metMay 28, 2026payer document
AetnaInebilizumab-cdon (Uplizna) (0975)listed, no stanceAug 11, 2026payer document
AetnaInfliximab (0341)listed, no stanceOct 5, 2026payer document
AetnaMepolizumab (Nucala) (0897)listed, no stance (range J7637-J7638)Aug 5, 2026payer document
AetnaOmalizumab (0670)listed, no stanceAug 21, 2026payer document
AetnaReslizumab (Cinqair) (0907)listed, no stance (range J7637-J7638)Aug 10, 2026payer document
AetnaRituximab (0314)listed, no stanceSep 15, 2026payer document
AetnaTezepelumab-ekko (Tezspire) (1003)listed, no stance (range J7637-J7638)Aug 6, 2026payer document

Medicaid fee-for-service

Prior authorization required or conditional in IN.

  • OH: $0.12 (provider_administered_drugs), effective Apr 1, 2006
  • VA: $0.12 (medical), effective Jul 1, 2005
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $0.10 (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.