J7640 Formoterol comp unit

Formoterol, inhalation solution, compounded product, administered through dme, unit dose form, 12 micrograms

Medically Unlikely Edits (effective October 1, 2026)

Medicare pricing for J7640

Physician Fee Schedule (CY 2026, RVU26D)

Status E: excluded from the PFS by regulation.

Payer policies and prior authorization for J7640

Payer coverage policies that name J7640

J7640 appears in 7 coverage policies from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaBenralizumab (Fasenra) (0925)listed, no stanceAug 25, 2026payer document
AetnaDepemokimab-ulaa (Exdensur) (1098)listed, no stanceAug 10, 2026payer document
AetnaMepolizumab (Nucala) (0897)listed, no stanceAug 5, 2026payer document
AetnaNebulizers (0065)covered if criteria are metMar 18, 2026payer document
AetnaOmalizumab (0670)listed, no stanceAug 21, 2026payer document
AetnaReslizumab (Cinqair) (0907)listed, no stanceAug 10, 2026payer document
AetnaTezepelumab-ekko (Tezspire) (1003)listed, no stanceAug 6, 2026payer document

Medicaid fee-for-service

Prior authorization required or conditional in IN.

  • CO: $0.03 (health_first_colorado), effective Jul 1, 2026
  • OH: $5.91 (provider_administered_drugs), effective Sep 1, 2013
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 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.