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J2315

J2315 – Injection, naltrexone, depot form, 1 mg · NDC Crosswalk & Billing Units

HCPCS Level II J-code · Medicare Part B drug billing
J-code ● 1 NDC crosswalked per 1 MG $4.525/unit ASP+6%

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

📋 J2315 summary

J2315 is a HCPCS Level II J-code used to bill naltrexone, depot form, 1 mg, billed per 1 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 J2315: Vivitrol

Code J2315 Billing unit 1 MG Payment limit $4.525/unit NDC-Crosswalk 1 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 codeJ2315
DescriptorInjection, naltrexone, depot form, 1 mg
Billing unit1 MG
Payment limit / unit$4.525
Est. ASP / unit$4.269 est.
Mapped NDCs1
Data periodQ3 2026
Last updated2026-08-20

💊 About Naltrexone DRUG GUIDE

Naltrexone Hydrochloride tablets are used to treat alcohol dependence and to block the effects of opioids in people with opioid dependence.

The extended-release injectable suspension — sold as Vivitrol and also available as a generic injectable — is used to treat alcohol dependence and to prevent relapse to opioid dependence after a person has completed opioid detoxification.All formulations are meant to be part of a broader treatment plan that includes counseling and other support — naltrexone works best when it is not used alone.

Read the full Naltrexone drug guide →
Clinical overview from our editorial drug guide for Naltrexone. 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
$4.525
Est. ASP / unit
$4.269 est.
Est. after 2% sequester
$4.435
HCPCS dosage
1 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, naltrexone, depot form, 1 mg
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 date2007-01-01
Date added2007-01-01
Source: CMS HCPCS Level II code file (imported via admin).

🧮 Dosing & billing-units calculator HCPCS UNITS

One billing unit of J2315 = 1 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 J2315 LEAST EXPENSIVE FIRST

1 NDC map to J2315. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($4.525/unit) × that package's bill units.
NDC (11-digit)DrugLabelerPackageStrength Bill units Est. pay / pkg NADAC / unit StatusSource
65757-0300-01 VIVITROL naltrexone KIT Alkermes, 1 KIT in 1 CARTON (65757-300-01) * 4 mL... — 380 $1,719.50 $1,716.480 ● 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
$866.4K
Claims
668
Beneficiaries
347
Spend / beneficiary
$2,496.74
Spend / claim
$1,296.96
Trend by period
Where J2315 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #393 of 824
#388 RIMSO-50 J1212 $909.6K #389 EPIXPRESS, PER SQ CM... Q4361 $906.3K #390 REBYOTA J1440 $905.2K #391 LAMZEDE J0217 $903.9K #392 ELELYSO J3060 $871.5K #393 VIVITROL J2315 $866.4K #394 SPEVIGO J1747 $863.1K #395 TEMOZOLOMIDE J8700 $858.1K #396 INTEGRA BMWD** Q4104 $855.9K #397 REZZAYO J0349 $844.7K #398 NIVESTYM Q5110 $835.2K
Total claims — #419 of 824
#414 TECENTRIQ HYBREZA J9024 688 #415 HYPERRAB 90375 686 #416 UPLIZNA J1823 686 #417 YONDELIS J9352 684 #418 ABILIFY MAINTENA J0401 670 #419 VIVITROL J2315 668 #420 METOPROLOL TARTRATE J0616 666 #421 ACAPATCH, PER SQ CM*... Q4325 661 #422 DURAMORPH* J2274 657 #423 KINEVAC* J2805 654 #424 CAREGRAFT, PER SQ CM... Q4322 652

Full breakdown by period (2)
PeriodTotal spendBeneficiariesClaims$/beneficiary$/claim
2026 (Q1) $866.4K 347 668 $2,496.74 $1,296.96
2025 (Q1-Q4) $3.28M 805 2,876 $4,075.90 $1,140.85
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
$1M
Medicare paid
$775.1K
Submitted services
448,718
Denial rate
22.4%
Allowed / service
$2.88
Submitted charges
$2.34M
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 J2315 is utilized CMS · BY PROVIDER · 2024

Medicare Part B services for this code by the rendering provider's state — 10,260 services across 1 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.

🗃️ 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
1 NDC 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.

❓ J2315 billing FAQ

What is HCPCS code J2315?
J2315 is a HCPCS Level II J-code used to bill Injection, naltrexone, depot form, 1 mg under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J2315?
One unit of J2315 represents 1 MG. Report the number of units equal to the dose administered divided by 1 MG.
How many units of J2315 should I bill?
Divide the dose administered by the code's unit size (1 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 J2315?
The Medicare Part B payment limit is $4.525 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $4.435 per unit. Payment limits are revised quarterly.
Which NDCs bill under J2315?
1 NDC currently map to J2315 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 J2315 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.