J0741
J0741 – Injection, cabotegravir and rilpivirine, 2mg/3mg · NDC Crosswalk & Billing Units
HCPCS Level II J-code · Medicare Part B drug billing
J-code
● 2 NDCs crosswalked per 2MG/3MG $24.667/unit ASP+6%
📋 J0741 summary
J0741 is a HCPCS Level II J-code used to bill cabotegravir and rilpivirine, 2mg/3mg, billed per 2MG/3MG. The number of billing units to report depends on the dose administered and the NDC/package billed — use the calculator below.
Brand names associated with J0741: Cabenuva
Code J0741
Billing unit 2MG/3MG Payment limit $24.667/unit NDC-Crosswalk 2
Quarter Q3 2026
RxCUI Atlas Trace the drug concept →
⚠ An NDC↔HCPCS crosswalk and a published payment limit do not guarantee payer coverage or payment. Always verify the current payer policy and claim format before billing.
🗂️ Key billing facts
HCPCS codeJ0741
DescriptorInjection, cabotegravir and rilpivirine, 2mg/3mg
Billing unit2MG/3MG
Payment limit / unit$24.667
Est. ASP / unit$23.271 est.
Mapped NDCs2
Data periodQ3 2026
Last updated2026-08-20
💊 About Cabotegravir and Rilpivirine Injections DRUG GUIDE
CABENUVA (cabotegravir + rilpivirine) is used to treat HIV-1 infection in adults and adolescents 12 years and older who weigh at least 35 kg (about 77 lbs).
It is not a starter treatment — it's designed for people who are already virologically suppressed, meaning their HIV is currently undetectable on a stable daily pill regimen and who have no history of treatment failure.The goal is to keep the virus fully suppressed while freeing the person from taking a pill every day.
Because it stays active in the body for weeks after each injection, strict adherence to the injection schedule is essential.
Clinical overview from our editorial drug guide for Cabotegravir and Rilpivirine Injections. For billing reference, see the sections above.
🧾 Billing & reimbursement HCPCS · CMS · EFF. Q3 2026
📅 Payment limits effective Q3 2026 — from the CMS Medicare Part B Payment Limit File (revised quarterly).
Medicare payment limit / unit
$24.667
Est. ASP / unit
$23.271 est.
Est. after 2% sequester
$24.174
HCPCS dosage
2MG/3MG
The CMS payment limit is the Medicare Part B drug allowance (ASP + 6%, statutory). After the 2% federal sequester the effective payment is ≈ ASP + 4.3%; estimated ASP = payment limit ÷ 1.06. Source: CMS Medicare Part B Payment Limit File (quarterly), Q3 2026.
Full HCPCS code details (official CMS record)
Long descriptionInjection, cabotegravir and rilpivirine, 2mg/3mg
CoverageC — Carrier/MAC judgment
Pricing indicator51 — Drug — priced under the ASP methodology
Type of service1 — Medical care
BETOS-2O1E
ASC payment groupYY
Action codeN — No maintenance this year
Effective date2021-10-01
Date added2021-10-01
Source: CMS HCPCS Level II code file (imported via admin).
🧮 Dosing & billing-units calculator HCPCS UNITS
One billing unit of J0741 = 2 mg. Enter a regimen to convert dose → billing units and project a full course.
Billing units = dose ÷ HCPCS unit size. Most payers require whole units — round per the payer's policy. “Est. Medicare pay” uses the current payment limit. For single-dose vials, drug discarded after administration may be separately billable with modifier JW (JZ when none is discarded) where allowed. Always verify payer-specific rounding before billing.
🔁 NDCs that bill under J0741 WITH EST. MEDICARE PAY
2 NDCs map to J0741. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($24.667/unit) × that package's bill units.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | Est. pay / pkg | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|---|
| 49702-0240-15 | Cabenuva cabotegravir and rilpivirine KIT | ViiV | 1 KIT in 1 CARTON (49702-240-15) * 3 mL... | — | 300 | $7,400.10 | — | ● Active | CMS ASP |
| 49702-0253-15 | Cabenuva cabotegravir and rilpivirine KIT | ViiV | 1 KIT in 1 CARTON (49702-253-15) * 2 mL... | — | 200 | $4,933.40 | — | ● Active | CMS ASP |
NDC→HCPCS mappings come from the CMS ASP NDC-HCPCS crosswalk; additional DME MAC / DMEPOS mappings come from PDAC and are labeled separately. NADAC from CMS (weekly). “Status” reflects the product's marketing / obsolete flag in the NDC directory. Presence or absence here does not determine Medicare coverage. Linked NDCs open the full product page.
📊 Medicare utilization & spend CMS · PART B · 2026 (Q1)
Period
Total Part B spend
$5.49M
Claims
920
Beneficiaries
607
Spend / beneficiary
$9,036.82
Spend / claim
$5,962.34
Trend by period
Where J0741 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #232 of 824
#227
HERCESSI Q5146
$5.85M
#228
CAMCEVI J1952
$5.75M
#229
VIVIMUSTA J9056
$5.63M
#230
ORTHOVISC J7324
$5.56M
#231
BUDESONIDE* J7626
$5.49M
#232
CABENUVA J0741
$5.49M
#233
PEMRYDI RTU J9324
$5.46M
#234
STIMUFEND Q5127
$5.42M
#235
FOLOTYN* J9307
$5.4M
#236
NOVOSEVEN RT J7189
$5.33M
#237
CUTAQUIG J1551
$5.29M
Total claims — #383 of 824
#378
APRETUDE J0739
959
#379
OASIS ULTRA Q4124
939
#380
BLINCYTO J9039
933
#381
MANNITOL(J2151) J2151
925
#382
BEOVU J0179
920
#383
CABENUVA J0741
920
#384
ORPHENADRINE CITRATE J2360
916
#385
PEMRYDI RTU J9324
903
#386
ENJAYMO J1302
892
#387
ASTAGRAF XL J7508
883
#388
PIPERACILLIN-TAZOBAC... J2543
873
Top Medicare Part B drugs by the selected metric. Click any drug to open its J-code page. Source: CMS Medicare Quarterly Part B Spending by Drug.
Full breakdown by period (2)
| Period | Total spend | Beneficiaries | Claims | $/beneficiary | $/claim |
|---|---|---|---|---|---|
| 2026 (Q1) | $5.49M | 607 | 920 | $9,036.82 | $5,962.34 |
| 2025 (Q1-Q4) | $19.42M | 1,104 | 3,864 | $17,586.22 | $5,024.64 |
Provider-administered (Part B) spend, calculated for the whole HCPCS code (CMS does not publish Medicare spend per individual NDC). Self-administered use is covered under Part D instead. A blank patient count means fewer than 11 people — CMS hides counts that small to protect privacy. Source: CMS Medicare Quarterly Part B Spending by Drug (data.cms.gov), updated quarterly.
📈 Medicare Part B claims detail CMS PSPS · 2024
Calendar-year 2024 Medicare Part B fee-for-service activity for this HCPCS code, summed across all carriers, localities and specialties (CMS Physician/Supplier Procedure Summary). A “service” is one billed line/unit — not one claim — so counts run higher than claim counts.
Allowed charges
$5.78M
Medicare paid
$4.47M
Submitted services
430,370
Denial rate
29.3%
Allowed / service
$19.00
Submitted charges
$13.82M
Source: CMS Physician/Supplier Procedure Summary (PSPS), CY2024 — Medicare Part B carrier + DME fee-for-service claims (excludes Medicare Advantage). Figures are for the whole HCPCS code, which may cover uses beyond this drug. ⚠ CMS hides any figure covering fewer than 11 patients (a privacy rule), so totals — especially denials and low-volume codes — run a little low.
🗺️ Where J0741 is utilized
⏳
The geographic utilization map is building for this code — it aggregates millions of CMS Part B claim lines, then caches the result. Refresh in a moment; if it doesn’t appear, this code may have no reportable Part B utilization.
🗃️ Data sources & freshness
Every figure on this page is computed from public datasets. Here's what each section draws on and how current it is.
HCPCS code & descriptor
CMS HCPCS Level II code file
Loaded
Payment limit & billing unit
CMS Medicare Part B ASP Pricing File (quarterly)
Q3 2026 · as of 2026-08-20
NDC ↔ HCPCS crosswalk
CMS ASP NDC-HCPCS crosswalk
2 NDCs mapped
NADAC acquisition cost
CMS National Average Drug Acquisition Cost (weekly)
Not available for mapped NDCs
Utilization & spend
CMS Part B Spending by Drug · PSPS · Physician & Other Practitioners
Latest data year 2026
Figures are estimates for reference and may lag the source files. Always verify against the current CMS files and your payer's policy before submitting claims.
⚠️ Practical billing caveats
- A crosswalk is not coverage. An NDC mapping or a published payment limit does not guarantee a payer will cover or pay this code. Check the specific plan's policy.
- Units ≠ milligrams. Bill the number of HCPCS units (dose ÷ the code's unit size), not the milligram dose. Use the calculator above.
- Discarded drug. For single-dose vials, drug discarded after administration may be separately billable with modifier JW (and JZ when nothing is discarded) where the payer allows.
- Rounding & partial units. Many payers require whole units; round per the payer's policy, not automatically up.
- The code can cover more than this drug. Some HCPCS codes span multiple products or strengths — confirm the exact code for the product administered.
- Figures lag. ASP limits change quarterly and utilization data are released with a delay. Verify against the current CMS files before billing.
❓ J0741 billing FAQ
What is HCPCS code J0741?
J0741 is a HCPCS Level II J-code used to bill Injection, cabotegravir and rilpivirine, 2mg/3mg under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J0741?
One unit of J0741 represents 2MG/3MG. Report the number of units equal to the dose administered divided by 2MG/3MG.
How many units of J0741 should I bill?
Divide the dose administered by the code's unit size (2MG/3MG) to get the number of billing units, then round per your payer's policy. The calculator on this page converts a dose into billing units and projects a full course.
How much does Medicare pay for J0741?
The Medicare Part B payment limit is $24.667 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $24.174 per unit. Payment limits are revised quarterly.
Which NDCs bill under J0741?
2 NDCs currently map to J0741 in the CMS ASP NDC-HCPCS crosswalk. See the NDC crosswalk table above for each product, package, billing units and estimated reimbursement.
Does a crosswalk mean J0741 is covered?
No. An NDC-to-HCPCS crosswalk and a published payment limit do not guarantee coverage or payment. Coverage depends on the payer, the diagnosis and the site of care — always verify the current policy before billing.
For professional billing reference only — verify against the current CMS files before submitting claims.