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J1631

J1631 – Injection, haloperidol decanoate, per 50 mg · NDC Crosswalk & Billing Units

HCPCS Level II J-code · Medicare Part B drug billing
J-code ● 74 NDCs crosswalked per 50 MG $5.291/unit ASP+6%

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

📋 J1631 summary

J1631 is a HCPCS Level II J-code used to bill haloperidol decanoate, per 50 mg, billed per 50 MG. 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 J1631: Haldol Decanoate, Haloperidol Decanoate

Code J1631 Billing unit 50 MG Payment limit $5.291/unit NDC-Crosswalk 74 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 codeJ1631
DescriptorInjection, haloperidol decanoate, per 50 mg
Billing unit50 MG
Payment limit / unit$5.291
Est. ASP / unit$4.992 est.
Mapped NDCs74
Data periodQ3 2026
Last updated2026-08-20

💊 About Haloperidol Injection DRUG GUIDE

Haloperidol Decanoate injection (sold as Haldol Decanoate and Haloperidol Decanoate) is approved to treat schizophrenia in adults who were already stable on oral haloperidol.

It is a long-acting, once-monthly option designed for people who need ongoing antipsychotic treatment.Haloperidol Decanoate injection is not approved for dementia-related psychosis.

Using it in elderly patients with dementia carries a serious risk of death.

Read the full Haloperidol Injection drug guide →
Clinical overview from our editorial drug guide for Haloperidol Injection. 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
$5.291
Est. ASP / unit
$4.992 est.
Est. after 2% sequester
$5.185
HCPCS dosage
50 MG
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, haloperidol decanoate, per 50 mg
CoverageD — Special coverage instructions apply
Pricing indicator51 — Drug — priced under the ASP methodology
Type of service1 — Medical care
BETOS-2O1E
ASC payment group—
Action codeN — No maintenance this year
Effective date1997-01-01
Date added1989-01-01
Source: CMS HCPCS Level II code file (imported via admin).

🧮 Dosing & billing-units calculator HCPCS UNITS

One billing unit of J1631 = 50 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 J1631 LEAST EXPENSIVE FIRST

74 NDCs map to J1631. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($5.291/unit) × that package's bill units.
NDC (11-digit)DrugLabelerPackageStrength Bill units Est. pay / pkg NADAC / unit StatusSource
25021-0831-01 haloperidol decanoate 50 mg/mL INJECTION, SOLUTION Sagent 10 VIAL in 1 CARTON (25021-831-01) / 1 mL... 50 mg/mL 10 $52.91 $6.740 ● Active CMS + PDAC
65145-0168-10 Haloperidol Decanoate 50 mg/mL INJECTION Caplin 10 VIAL, SINGLE-DOSE in 1 CARTON (65145-16... 50 mg/mL 10 $52.91 $6.740 ● Active CMS + PDAC
67457-0410-13 Haloperidol Decanoate 50 mg/mL INJECTION Mylan 10 VIAL in 1 CARTON (67457-410-13) / 1 mL... 50 mg/mL 10 $52.91 $6.740 ● Active CMS ASP
70069-0381-10 HALOPERIDOL DECANOATE 50 mg/mL INJECTION Somerset 10 VIAL, SINGLE-DOSE in 1 CARTON (70069-38... 50 mg/mL 10 $52.91 $6.740 ● Active CMS + PDAC
70710-1461-06 Haloperidol decanoate 50 mg/mL INJECTION Zydus 10 VIAL, SINGLE-DOSE in 1 CARTON (70710-14... 50 mg/mL 10 $52.91 $6.740 ● Active CMS + PDAC
70756-0615-10 Haloperidol Decanoate 50 mg/mL INJECTION Lifestar 10 VIAL in 1 CARTON (70756-615-10) / 1 mL... 50 mg/mL 10 $52.91 $6.740 ● Active CMS + PDAC
71288-0502-02 Haloperidol Decanoate 50 mg/mL INJECTION Meitheal 10 VIAL, SINGLE-DOSE in 1 CARTON (71288-50... 50 mg/mL 10 $52.91 $6.740 ● Active CMS + PDAC
70069-0866-10 HALOPERIDOL DECANOATE 50 mg/mL INJECTION Somerset 10 VIAL in 1 CARTON (70069-866-10) / 1 mL... 50 mg/mL 1 $5.29 $6.740 ● Active PDAC
25021-0833-01 haloperidol decanoate 100 mg/mL INJECTION, SOLUTION Sagent 10 VIAL in 1 CARTON (25021-833-01) / 1 mL... 100 mg/mL 20 $105.82 $7.439 ● Active CMS + PDAC
65145-0167-10 Haloperidol Decanoate 100 mg/mL INJECTION Caplin 10 VIAL, SINGLE-DOSE in 1 CARTON (65145-16... 100 mg/mL 20 $105.82 $7.439 ● Active CMS + PDAC
70756-0616-10 Haloperidol Decanoate 100 mg/mL INJECTION Lifestar 10 VIAL in 1 CARTON (70756-616-10) / 1 mL... 100 mg/mL 20 $105.82 $7.439 ● Active CMS + PDAC
71288-0503-02 Haloperidol Decanoate 100 mg/mL INJECTION Meitheal 10 VIAL, SINGLE-DOSE in 1 CARTON (71288-50... 100 mg/mL 20 $105.82 $7.439 ● Active CMS + PDAC
70069-0383-10 HALOPERIDOL DECANOATE 100 mg/mL INJECTION Somerset 10 VIAL, SINGLE-DOSE in 1 CARTON (70069-38... 100 mg/mL 2 $10.58 $7.439 ● Active PDAC
68001-0657-51 Haloperidol decanoate 50 mg/mL INJECTION BluePoint 3 VIAL, SINGLE-DOSE in 1 CARTON (68001-657... 50 mg/mL 3 $15.87 $12.109 ● Active CMS + PDAC
70710-1461-09 Haloperidol decanoate 50 mg/mL INJECTION Zydus 3 VIAL, SINGLE-DOSE in 1 CARTON (70710-146... 50 mg/mL 3 $15.87 $12.109 ● Active CMS + PDAC
63323-0469-01 Haloperidol Decanoate 50 mg/mL INJECTION Fresenius 1 VIAL in 1 CARTON (63323-469-01) / 1 mL... 50 mg/mL 1 $5.29 $12.467 ● Active CMS + PDAC
70069-0381-01 HALOPERIDOL DECANOATE 50 mg/mL INJECTION Somerset 1 VIAL, SINGLE-DOSE in 1 CARTON (70069-381... 50 mg/mL 1 $5.29 $12.744 ● Active CMS ASP
70756-0615-81 Haloperidol Decanoate 50 mg/mL INJECTION Lifestar 1 VIAL in 1 CARTON (70756-615-81) / 1 mL... 50 mg/mL 1 $5.29 $12.744 ● Active CMS + PDAC
68001-0580-41 HALOPERIDOL DECANOATE 50 mg/mL INJECTION BluePoint 1 VIAL, SINGLE-DOSE in 1 CARTON (68001-580... 50 mg/mL 1 $5.29 $12.748 ● Active CMS + PDAC
00143-9296-01 Haloperidol Decanoate 100 mg/mL INJECTION Hikma 1 VIAL in 1 BOX (0143-9296-01) / 5 mL in... 100 mg/mL 10 $52.91 $14.324 ● Active CMS + PDAC
25021-0834-05 haloperidol decanoate 500 mg/5mL INJECTION, SOLUTION Sagent 1 VIAL in 1 CARTON (25021-834-05) / 5 mL... 500 mg/5mL 10 $52.91 $14.324 ● Active CMS + PDAC
63323-0471-05 Haloperidol Decanoate 100 mg/mL INJECTION Fresenius 1 VIAL, MULTI-DOSE in 1 CARTON (63323-471-... 100 mg/mL 10 $52.91 $14.324 ● Active CMS + PDAC
65145-0169-01 Haloperidol Decanoate 100 mg/mL INJECTION Caplin 1 VIAL, MULTI-DOSE in 1 CARTON (65145-169-... 100 mg/mL 10 $52.91 $14.324 ● Active CMS + PDAC
67457-0409-13 Haloperidol Decanoate 100 mg/mL INJECTION Mylan 5 VIAL in 1 CARTON (67457-409-13) / 1 mL... 100 mg/mL 10 $52.91 $14.324 ● Active CMS ASP
68001-0581-48 HALOPERIDOL DECANOATE 100 mg/mL INJECTION BluePoint 5 VIAL, SINGLE-DOSE in 1 CARTON (68001-581... 100 mg/mL 10 $52.91 $14.324 ● Active CMS + PDAC
68001-0658-52 Haloperidol decanoate 100 mg/mL INJECTION BluePoint 5 VIAL, SINGLE-DOSE in 1 CARTON (68001-658... 100 mg/mL 10 $52.91 $14.324 ● Active CMS + PDAC
68001-0659-41 Haloperidol decanoate 500 mg/5mL INJECTION BluePoint 1 VIAL, MULTI-DOSE in 1 CARTON (68001-659-... 500 mg/5mL 10 $52.91 $14.324 ● Active CMS + PDAC
70069-0383-05 HALOPERIDOL DECANOATE 100 mg/mL INJECTION Somerset 5 VIAL, SINGLE-DOSE in 1 CARTON (70069-383... 100 mg/mL 10 $52.91 $14.324 ● Active CMS + PDAC
70069-0384-01 HALOPERIDOL DECANOATE 100 mg/mL INJECTION Somerset 1 VIAL, MULTI-DOSE in 1 CARTON (70069-384-... 100 mg/mL 10 $52.91 $14.324 ● Active CMS + PDAC
70710-1463-05 Haloperidol decanoate 100 mg/mL INJECTION Zydus 5 VIAL, SINGLE-DOSE in 1 CARTON (70710-146... 100 mg/mL 10 $52.91 $14.324 ● Active CMS + PDAC
70710-1464-01 Haloperidol decanoate 100 mg/mL INJECTION Zydus 1 VIAL, MULTI-DOSE in 1 CARTON (70710-1464... 100 mg/mL 10 $52.91 $14.324 ● Active CMS + PDAC
70756-0625-85 Haloperidol Decanoate 500 mg/5mL INJECTION Lifestar 1 VIAL in 1 CARTON (70756-625-85) / 5 mL... 500 mg/5mL 10 $52.91 $14.324 ● Active CMS + PDAC
71288-0504-05 Haloperidol Decanoate 100 mg/mL INJECTION Meitheal 1 VIAL, MULTI-DOSE in 1 CARTON (71288-504-... 100 mg/mL 10 $52.91 $14.324 ● Active CMS + PDAC
70069-0867-05 HALOPERIDOL DECANOATE 100 mg/mL INJECTION Somerset 5 CARTON in 1 CARTON (70069-867-05) / 10... 100 mg/mL 2 $10.58 $14.324 ● Active PDAC
70069-0868-01 HALOPERIDOL DECANOATE 100 mg/mL INJECTION Somerset 1 VIAL in 1 CARTON (70069-868-01) / 5 mL... 100 mg/mL 2 $10.58 $14.324 ● Active PDAC
00143-9295-01 Haloperidol Decanoate 100 mg/mL INJECTION Hikma 1 VIAL in 1 BOX (0143-9295-01) / 1 mL in... 100 mg/mL 2 $10.58 $16.016 ● Active CMS + PDAC
63323-0471-01 Haloperidol Decanoate 100 mg/mL INJECTION Fresenius 1 VIAL in 1 CARTON (63323-471-01) / 1 mL... 100 mg/mL 2 $10.58 $16.016 ● Active CMS + PDAC
63323-0471-41 Haloperidol Decanoate 100 mg/mL INJECTION Fresenius 1 VIAL in 1 CARTON (63323-471-41) / 1 mL... 100 mg/mL 2 $10.58 $16.016 ● Active CMS + PDAC
68001-0581-41 HALOPERIDOL DECANOATE 100 mg/mL INJECTION BluePoint 1 VIAL, SINGLE-DOSE in 1 CARTON (68001-581... 100 mg/mL 2 $10.58 $16.016 ● Active CMS + PDAC
68001-0658-41 Haloperidol decanoate 100 mg/mL INJECTION BluePoint 1 VIAL, SINGLE-DOSE in 1 CARTON (68001-658... 100 mg/mL 2 $10.58 $16.016 ● Active CMS + PDAC
70069-0383-01 HALOPERIDOL DECANOATE 100 mg/mL INJECTION Somerset 1 VIAL, SINGLE-DOSE in 1 CARTON (70069-383... 100 mg/mL 2 $10.58 $16.016 ● Active CMS ASP
70710-1463-01 Haloperidol decanoate 100 mg/mL INJECTION Zydus 1 VIAL, SINGLE-DOSE in 1 CARTON (70710-146... 100 mg/mL 2 $10.58 $16.016 ● Active CMS + PDAC
70756-0616-81 Haloperidol Decanoate 100 mg/mL INJECTION Lifestar 1 VIAL in 1 CARTON (70756-616-81) / 1 mL... 100 mg/mL 2 $10.58 $16.016 ● Active CMS + PDAC
72603-0230-01 Haloperidol Decanoate 100 mg/mL INJECTION NorthStar 1 VIAL in 1 CARTON (72603-230-01) / 1 mL... 100 mg/mL 2 $10.58 $16.016 ● Active CMS + PDAC
10147-0921-03 Haloperidol Decanoate 50 mg/mL INJECTION Patriot 3 AMPULE in 1 BOX (10147-0921-3) / 1 mL i... 50 mg/mL 3 $15.87 $20.085 ● Active CMS ASP
68001-0578-48 HALOPERIDOL DECANOATE 50 mg/mL INJECTION BluePoint 3 AMPULE in 1 CARTON (68001-578-48) / 1 m... 50 mg/mL 3 $15.87 $20.085 ● Active CMS + PDAC
70069-0030-03 HALOPERIDOL DECANOATE 50 mg/mL INJECTION Somerset 3 AMPULE in 1 CARTON (70069-030-03) / 1 m... 50 mg/mL 3 $15.87 $20.598 ● Active CMS + PDAC
68001-0582-41 HALOPERIDOL DECANOATE 500 mg/5mL INJECTION BluePoint 1 VIAL, MULTI-DOSE in 1 CARTON (68001-582-... 500 mg/5mL 10 $52.91 $26.499 ● Active CMS + PDAC
10147-0922-05 Haloperidol Decanoate 100 mg/mL INJECTION Patriot 5 AMPULE in 1 BOX (10147-0922-5) / 1 mL i... 100 mg/mL 10 $52.91 $29.346 ● Active CMS ASP
68001-0579-48 HALOPERIDOL DECANOATE 100 mg/mL INJECTION BluePoint 5 AMPULE in 1 CARTON (68001-579-48) / 1 m... 100 mg/mL 10 $52.91 $29.346 ● Active CMS + PDAC
70069-0031-05 HALOPERIDOL DECANOATE 100 mg/mL INJECTION Somerset 5 AMPULE in 1 CARTON (70069-031-05) / 1 m... 100 mg/mL 10 $52.91 $32.927 ● Active CMS + PDAC
50458-0253-03 Haldol Decanoate Haloperidol 50 mg/mL INJECTION Janssen 3 AMPULE in 1 BOX (50458-253-03) / 1 mL i... 50 mg/mL 3 $15.87 — ● Active CMS ASP
50458-0254-14 Haldol Decanoate Haloperidol 100 mg/mL INJECTION Janssen 5 AMPULE in 1 BOX (50458-254-14) / 1 mL i... 100 mg/mL 10 $52.91 — ● Active CMS ASP
63323-0469-05 Haloperidol Decanoate 50 mg/mL INJECTION Fresenius 1 VIAL, MULTI-DOSE in 1 CARTON (63323-469-... 50 mg/mL 5 $26.46 — ● Active CMS + PDAC
68001-0581-82 HALOPERIDOL DECANOATE 100 mg/mL INJECTION BluePoint 10 VIAL, SINGLE-DOSE in 1 CARTON (68001-58... 100 mg/mL 20 $105.82 — ● Active CMS + PDAC
70710-1464-05 Haloperidol decanoate 100 mg/mL INJECTION Zydus 5 VIAL, MULTI-DOSE in 1 CARTON (70710-1464... 100 mg/mL 50 $264.55 — ● Active CMS + PDAC
70756-0624-85 Haloperidol Decanoate 250 mg/5mL INJECTION Lifestar 1 VIAL in 1 CARTON (70756-624-85) / 5 mL... 250 mg/5mL 1 $5.29 — ● Active PDAC
70756-0625-10 Haloperidol Decanoate 500 mg/5mL INJECTION Lifestar 10 VIAL in 1 CARTON (70756-625-10) / 5 mL... 500 mg/5mL 2 $10.58 — ● Active PDAC
70756-0625-05 Haloperidol Decanoate 500 mg/5mL INJECTION Lifestar 5 VIAL in 1 CARTON (70756-625-05) / 5 mL... 500 mg/5mL 2 $10.58 — ● Active PDAC
70710-1462-01 Haloperidol decanoate 50 mg/mL INJECTION Zydus 1 VIAL, MULTI-DOSE in 1 CARTON (70710-1462... 50 mg/mL 1 $5.29 — ● Active PDAC
60505-6020-02 NOVAPLUS HALOPERIDOL DECANOATE (1X5ML,MDV) 50 MG/ML Unknown — — 1 $5.29 — — PDAC
60505-6021-02 NOVAPLUS HALOPERIDOL DECANOATE (1X5ML,MDV) 100 MG/ML Unknown — — 2 $10.58 — — PDAC
63323-0471-44 PREMIERPRO RX HALOPERIDOL DECANOATE 100 MG/1 ML Unknown — — 2 $10.58 — — PDAC
68001-0657-56 HALOPERIDOL DECANOATE SDV 50 MG/1 ML Unknown — — 1 $5.29 — — PDAC
00703-7123-01 HALOPERIDOL DECANOATE (MDV) 50 MG/1 ML Unknown — — 1 $5.29 — — PDAC
70069-0384-05 HALOPERIDOL DECANOATE 100 mg/mL INJECTION Somerset 5 VIAL, MULTI-DOSE in 1 CARTON (70069-384-... 100 mg/mL 2 $10.58 — ● Active PDAC
00703-7121-03 HALOPERIDOL DECANOATE (10X1ML) 50 MG/1 ML Unknown — — 1 $5.29 — — PDAC
72785-0007-01 HALOPERIDOL DECANOATE (MDV,LATEX-FREE) 100 MG/1 ML Unknown — — 2 $10.58 — — PDAC
00703-7133-01 HALOPERIDOL DECANOATE ((M.D.V.),1X5ML) 100 MG/1 ML Unknown — — 2 $10.58 — — PDAC
00703-7131-03 HALOPERIDOL DECANOATE (SDV) 100 MG/1 ML Unknown — — 2 $10.58 — — PDAC
00703-7023-01 HALOPERIDOL DECANOATE (M.D.V.) 100 MG/ML Unknown — — 2 $10.58 — — PDAC
00703-7021-03 HALOPERIDOL DECANOATE (VIAL) 100 MG/ML Unknown — — 2 $10.58 — — PDAC
00703-7013-01 HALOPERIDOL DECANOATE (M.D.V.) 50 MG/ML Unknown — — 1 $5.29 — — PDAC
00703-7011-03 HALOPERIDOL DECANOATE (VIAL) 50 MG/ML Unknown — — 1 $5.29 — — 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.

📊 Medicare utilization & spend CMS · PART B · 2026 (Q1)

Period
Total Part B spend
$3.1K
Claims
573
Beneficiaries
269
Spend / beneficiary
$11.44
Spend / claim
$5.37
Trend by period
Where J1631 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #729 of 824
#724 MESNA* J9209 $3.4K #725 CYSTO-CONRAY II* Q9958 $3.3K #726 ENGERIX-B PEDIATRIC-... 90744 $3.2K #727 TESTOSTERONE ENANTHA... J3121 $3.1K #728 DOPAMINE HCL IN 5% D... J1265 $3.1K #729 HALDOL DECANOATE 100... J1631 $3.1K #730 GEMCITABINE HCL(J919... J9196 $3K #731 PAMIDRONATE DISODIUM J2430 $3K #732 LEVOFLOXACIN-D5W J1956 $2.9K #733 CLEOCIN PHOSPHATE* J0736 $2.8K #734 MANNITOL(J2151) J2151 $2.8K
Total claims — #439 of 824
#434 VEKLURY J0248 604 #435 BRIUMVI J2329 599 #436 MULTIHANCE MULTIPACK A9578 598 #437 METOCLOPRAMIDE HCL J2765 585 #438 AXTLE J9292 584 #439 HALDOL DECANOATE 100... J1631 573 #440 PEMETREXED DISODIUM(... J9294 568 #441 DEXRAZOXANE J1190 567 #442 TESTOSTERONE ENANTHA... J3121 558 #443 DELESTROGEN* J1380 557 #444 TOPOTECAN HCL J9351 553

Full breakdown by period (2)
PeriodTotal spendBeneficiariesClaims$/beneficiary$/claim
2026 (Q1) $3.1K 269 573 $11.44 $5.37
2025 (Q1-Q4) $23.7K 577 3,227 $41.08 $7.35
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
$21.1K
Medicare paid
$12.9K
Submitted services
14,708
Denial rate
60.5%
Allowed / service
$3.63
Submitted charges
$142.7K
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 J1631 is utilized CMS · BY PROVIDER · 2024

Medicare Part B services for this code by the rendering provider's state — 1,854 services across 3 states & territories in 2024 (CMS reports include DC and U.S. territories). Switch to per 100k to compare states fairly regardless of population. Hover or tap a state for its top ZIP codes.
Hover or tap a state to see its numbers + top ZIP codes.
Per-capita = services ÷ 2023 state population × 100,000 (so high-population states aren't automatically "hotter"). Counts reflect the provider's location, not the patient's. Providers with fewer than 11 patients are hidden by CMS for privacy, so totals run low and per-100k can be noisy in small states — read this as relative geography, not exact counts. Source: CMS Medicare Physician & Other Practitioners — by Provider and Service, 2024.

📊 What bills under J1631

J-codes are billing codes often used for drugs billed under the medical benefit. This connects the billing code to the NDC package records it covers, by ingredient and labeler.

NDC products by ingredient
HALOPERIDOL DECANOATE 16
Haloperidol Decanoate 13
Haloperidol decanoate 11
haloperidol decanoate 3
NDC products by labeler
BluePoint Laboratories 8
Somerset Therapeutics, LLC 8
Zydus Pharmaceuticals USA Inc. 8
Lifestar Pharma LLC 4
Sagent Pharmaceuticals 3
Fresenius Kabi USA, LLC 3
Caplin Steriles Limited 3
Meitheal Pharmaceuticals Inc. 3

🗃️ 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 + DMEPDAC (PDAC)
74 NDCs mapped
NADAC acquisition cost
CMS National Average Drug Acquisition Cost (weekly)
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.

❓ J1631 billing FAQ

What is HCPCS code J1631?
J1631 is a HCPCS Level II J-code used to bill Injection, haloperidol decanoate, per 50 mg under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J1631?
One unit of J1631 represents 50 MG. Report the number of units equal to the dose administered divided by 50 MG.
How many units of J1631 should I bill?
Divide the dose administered by the code's unit size (50 MG) 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 J1631?
The Medicare Part B payment limit is $5.291 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $5.185 per unit. Payment limits are revised quarterly.
Which NDCs bill under J1631?
74 NDCs currently map to J1631 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 J1631 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.