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    HCPCS Details

    HCPC J3262
    Short Description Tocilizumab injection
    Long Description Injection, tocilizumab, 1 mg
    Pricing indicator 51
    Coverage code C
    ASC payment group code YY
    BETOS2 code O1E
    Action code N
    Type of service 1
    Effective date 2011-01-01
    Date Added 2011-01-01

    HCPCS/NDC Cross-Walk

    NDC HCPC Description Drug Name Labeler Name HCPCS Dosage PKG Size PKG QTY Bill Units Bill Units PKG
    50242013501 J3262 Tocilizumab injection Actemra GENENTECH, INC. 1 MG 4 1 80 80
    50242013601 J3262 Tocilizumab injection Actemra GENENTECH, INC. 1 MG 10 1 200 200
    50242013701 J3262 Tocilizumab injection Actemra GENENTECH, INC. 1 MG 20 1 400 400
    The ASP crosswalks are maintained by the Division of Data Analysis and Market Based Pricing to support ASP-based Medicare Part B payments only. The crosswalks are intended to help the public (including entities that submit manufacturer ASP data and providers who bill for drugs) understand which drug products (identified by NDCs) are assigned to which HCPCS billing codes. The crosswalks are not intended to be a comprehensive list of all drugs/NDCs available in the United States. The NDC to HCPCS Crosswalk also includes information on the NDC package size and the number of billable units (as defined by the HCPCS code descriptor). Comments on the file may be sent to [email protected].

    HCPCS Billing Calculator

    Dosage given to patient (per dose)
    HCPCS Dosage 1 MG
    HCPCS/CPT Billing Units 1
    Total doses ordered
    Billing Units 1

    Drug Details

    • Tocilizumab injection is used alone or in combination with other medications to relieve the symptoms of certain types of arthritis and other conditions including:

      • rheumatoid arthritis (a condition in which the body attacks its own joints, causing pain, swelling, and loss of function) in adults who have not been helped by other disease-modifying antirheumatic drugs (DMARDs),

      • giant cell arteritis (a condition that causes swelling of blood vessels, especially in the scalp and head) in adults,

      • systemic sclerosis-associated interstitial lung disease (SSc-ILD; also known as scleroderma-associated ILD: a lung disease that involves scarring of the lungs) in adults,

      • polyarticular juvenile idiopathic arthritis (PJIA; a type of childhood arthritis that affects five or more joints during the first six months of the condition, causing pain, swelling, and loss of function) in children 2 years of age or older.

      • systemic juvenile idiopathic arthritis (SJIA; a condition in children that causes inflammation in different areas of the body, causing fever, joint pain and swelling, loss of function, and delays in growth and development) in children 2 years of age or older,

      • cytokine release syndrome (a severe and possibly life-threatening reaction) in adults and children 2 years of age or older after receiving certain immunotherapy infusions.

    • Tocilizumab injection is in a class of medications called interleukin-6 (IL-6) receptor inhibitors. It works by blocking the activity of interleukin-6, a substance in the body that causes inflammation.