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J1412

J1412 – Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 · NDC Crosswalk & Billing Units

HCPCS Level II J-code · Medicare Part B drug billing
J-code ● 1 NDC crosswalked

This page is curated, coded, and maintained by

Compiled from public FDA, CMS, DailyMed, NADAC, and related drug data sources. Editorial policy

📋 J1412 summary

J1412 is a HCPCS Level II J-code used to bill valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes. The number of billing units to report depends on the dose administered and the NDC/package billed — use the calculator below.

Code J1412 NDC-Crosswalk 1 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 codeJ1412
DescriptorInjection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes
Billing unitNot available in current dataset
Payment limit / unit Not available in current dataset
Mapped NDCs1
Data periodNot available in current dataset
Last updatedSource date not available

🧾 Billing & reimbursement HCPCS · CMS

Medicare payment limit / unit
—
Est. ASP / unit
—
Est. after 2% sequester
—
HCPCS dosage
—
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).
Full HCPCS code details (official CMS record)
Long descriptionInjection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes
CoverageC — Carrier/MAC judgment
Pricing indicator51 — Drug — priced under the ASP methodology
Type of service1 — Medical care
BETOS-2O1E
ASC payment groupYY
Action codeA — Added this year
Effective date2024-01-01
Date added2024-01-01
Source: CMS HCPCS Level II code file (imported via admin).

🧮 Dosing & billing-units calculator HCPCS UNITS

One billing unit of J1412 = 1 unit. 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 J1412 CROSSWALKED NDCs

1 NDC map to J1412. Bill units = how many HCPCS units one package represents.
NDC (11-digit)DrugLabelerPackageStrength Bill units NADAC / unit StatusSource
68135-0927-48 ROCTAVIAN (PF,FROZEN) Unknown — — 1 — — PDAC
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.

🗺️ Where J1412 is utilized

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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)
Not available
NDC ↔ HCPCS crosswalk
CMS ASP NDC-HCPCS crosswalk + DMEPDAC (PDAC)
1 NDC 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
No reportable utilization
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.

❓ J1412 billing FAQ

What is HCPCS code J1412?
J1412 is a HCPCS Level II J-code used to bill Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes under Medicare Part B and most medical (not pharmacy) benefits.
Which NDCs bill under J1412?
1 NDC currently map to J1412 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 J1412 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.