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J1812

J1812 – Insulin (fiasp), per 5 units · NDC Crosswalk & Billing Units

HCPCS Level II J-code · Medicare Part B drug billing
J-code ● 2 NDCs crosswalked

This page is curated, coded, and maintained by

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

📋 J1812 summary

J1812 is a HCPCS Level II J-code used to bill Insulin (fiasp), per 5 units. 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 J1812: Fiasp

Code J1812 NDC-Crosswalk 2 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 codeJ1812
DescriptorInsulin (fiasp), per 5 units
Billing unitNot available in current dataset
Payment limit / unit Not available in current dataset
Mapped NDCs2
Data periodNot available in current dataset
Last updatedSource date not available

💊 About Insulin Aspart (rDNA Origin) Injection DRUG GUIDE

Insulin aspart is used to improve blood sugar (glucose) control in people with diabetes mellitus.

It is approved for both type 1 and type 2 diabetes in adults, and for diabetes mellitus in pediatric patients.Insulin Aspart Protamine and Insulin Aspart Mix 70/30 is a pre-mixed product that combines a rapid-acting and an intermediate-acting insulin aspart.

It is approved to improve blood sugar control in adult patients with diabetes mellitus.

It is not recommended for treating diabetic ketoacidosis, and because its ratio of rapid-acting to intermediate-acting insulin is fixed, it does not allow for separate mealtime versus background dose adjustments.

Read the full Insulin Aspart (rDNA Origin) Injection drug guide →
Clinical overview from our editorial drug guide for Insulin Aspart (rDNA Origin) Injection. For billing reference, see the sections above.

🧾 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 descriptionInsulin (fiasp), per 5 units
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 date2023-07-01
Date added2023-07-01
Source: CMS HCPCS Level II code file (imported via admin).

🧮 Dosing & billing-units calculator HCPCS UNITS

One billing unit of J1812 = 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 J1812 LEAST EXPENSIVE FIRST

2 NDCs map to J1812. Bill units = how many HCPCS units one package represents.
NDC (11-digit)DrugLabelerPackageStrength Bill units NADAC / unit StatusSource
00169-3205-15 Fiasp insulin aspart injection 100 [iU]/mL INJECTION, SOLUTION Novo 5 CARTRIDGE in 1 CARTON (0169-3205-15) /... 100 [iU]/mL 20 $8.538 ● Active PDAC
00169-3204-15 Fiasp insulin aspart injection 100 [iU]/mL INJECTION, SOLUTION Novo 5 SYRINGE, PLASTIC in 1 CARTON (0169-3204-... 100 [iU]/mL 20 $8.912 ● Active 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 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
$0.00
Medicare paid
$0.00
Submitted services
48
Denial rate
100.0%
Submitted charges
$16.7K
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.

📊 What bills under J1812

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
insulin aspart injection 2
NDC products by labeler
Novo Nordisk 2

🗃️ 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)
2 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
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.

❓ J1812 billing FAQ

What is HCPCS code J1812?
J1812 is a HCPCS Level II J-code used to bill Insulin (fiasp), per 5 units under Medicare Part B and most medical (not pharmacy) benefits.
Which NDCs bill under J1812?
2 NDCs currently map to J1812 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 J1812 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.