J3301
J3301 – Injection, triamcinolone acetonide, not otherwise specified, 10 mg · NDC Crosswalk & Billing Units
HCPCS Level II J-code · Medicare Part B drug billing
J-code
● 48 NDCs crosswalked per 10 MG $0.996/unit ASP+6%
📋 J3301 summary
J3301 is a HCPCS Level II J-code used to bill triamcinolone acetonide, not otherwise specified, 10 mg, billed per 10 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 J3301: Kenalog-10*, Kenalog-40, Kenalog-80
Code J3301
Billing unit 10 MG Payment limit $0.996/unit NDC-Crosswalk 48
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 codeJ3301
DescriptorInjection, triamcinolone acetonide, not otherwise specified, 10 mg
Billing unit10 MG
Payment limit / unit$0.996
Est. ASP / unit$0.940 est.
Mapped NDCs48
Data periodQ3 2026
Last updated2026-08-20
💊 About Triamcinolone DRUG GUIDE
Triamcinolone is available in many forms — injections, creams, ointments, nasal sprays, dental pastes, and eye injections — each approved for specific uses.
Injectable forms given into muscle are used when oral steroids aren't an option, covering severe allergies (like asthma flares, severe skin reactions, drug reactions, and serum sickness), serious skin diseases, certain endocrine (hormonal) disorders, and more.Injections given directly into a joint (intra-articular) or soft tissue help with conditions like rheumatoid arthritis, gout flares, bursitis, and tendon inflammation.
Injections into skin lesions (intralesional) treat conditions such as keloids, alopecia areata, and psoriatic plaques.
Triesence (an ophthalmic injection) is specifically indicated for eye conditions like uveitis and temporal arteritis, and for visualization during eye surgery.
Clinical overview from our editorial drug guide for Triamcinolone. 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
$0.996
Est. ASP / unit
$0.940 est.
Est. after 2% sequester
$0.976
HCPCS dosage
10 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, triamcinolone acetonide, not otherwise specified, 10 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 date2009-01-01
Date added1991-01-01
Source: CMS HCPCS Level II code file (imported via admin).
🧮 Dosing & billing-units calculator HCPCS UNITS
One billing unit of J3301 = 10 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 J3301 LEAST EXPENSIVE FIRST
48 NDCs map to J3301. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($0.996/unit) × that package's bill units.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | Est. pay / pkg | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|---|
| 00003-0494-20 | KENALOG-10 TRIAMCINOLONE ACETONIDE 10 mg/mL INJECTION, SUSPENSION | E.R. | 1 VIAL, MULTI-DOSE in 1 CARTON (0003-0494-... | 10 mg/mL | 5 | $4.98 | $2.322 | ● Active | CMS + PDAC |
| 55150-0385-01 | Triamcinolone Acetonide 40 mg/mL INJECTION, SUSPENSION | Eugia | 1 VIAL, MULTI-DOSE in 1 CARTON (55150-385-... | 40 mg/mL | 40 | $39.84 | $3.294 | ● Active | CMS + PDAC |
| 00143-9387-25 | Triamcinolone Acetonide 40 mg/mL INJECTION, SUSPENSION | Hikma | 25 VIAL in 1 CARTON (0143-9387-25) / 1 mL... | 40 mg/mL | 100 | $99.60 | $4.838 | ● Active | CMS + PDAC |
| 16714-0130-25 | Triamcinolone Acetonide 40 mg/mL INJECTION, SUSPENSION | NorthStar | 25 VIAL in 1 CARTON (16714-130-25) / 1 mL... | 40 mg/mL | 100 | $99.60 | $4.838 | ● Active | CMS + PDAC |
| 67457-0621-99 | TRIAMCINOLONE ACETONIDE 40 mg/mL INJECTION, SUSPENSION | Mylan | 25 VIAL, SINGLE-DOSE in 1 CARTON (67457-62... | 40 mg/mL | 100 | $99.60 | $4.838 | ● Active | CMS + PDAC |
| 70121-1049-05 | Triamcinolone Acetonide 40 mg/mL INJECTION, SUSPENSION | Amneal | 25 VIAL in 1 CARTON (70121-1049-5) / 1 mL... | 40 mg/mL | 100 | $99.60 | $4.838 | ● Active | CMS + PDAC |
| 70121-1651-05 | Triamcinolone Acetonide 40 mg/mL INJECTION, SUSPENSION | Amneal | 25 VIAL in 1 CARTON (70121-1651-5) / 1 mL... | 40 mg/mL | 100 | $99.60 | $4.838 | ● Active | CMS + PDAC |
| 81298-5781-05 | Triamcinolone Acetonide 40 mg/mL SUSPENSION | Long | 25 VIAL, SINGLE-USE in 1 CARTON (81298-578... | 40 mg/mL | 100 | $99.60 | $4.838 | ● Active | CMS + PDAC |
| 25021-0054-01 | Triamcinolone Acetonide 40 mg/mL INJECTION, SUSPENSION | Sagent | 25 VIAL in 1 CARTON (25021-054-01) / 1 mL... | 40 mg/mL | 4 | $3.98 | $4.838 | ● Active | PDAC |
| 00703-0245-01 | Triamcinolone Acetonide 40 mg/mL INJECTION, SUSPENSION | Teva | 1 VIAL, MULTI-DOSE in 1 CARTON (0703-0245-... | 40 mg/mL | 40 | $39.84 | $4.869 | ● Active | CMS + PDAC |
| 16714-0150-01 | Triamcinolone Acetonide 400 mg/10mL INJECTION, SUSPENSION | NorthStar | 1 VIAL in 1 CARTON (16714-150-01) / 10 mL... | 400 mg/10mL | 40 | $39.84 | $4.869 | ● Active | CMS + PDAC |
| 70121-1169-01 | Triamcinolone Acetonide 400 mg/10mL INJECTION, SUSPENSION | Amneal | 1 VIAL, MULTI-DOSE in 1 CARTON (70121-1169... | 400 mg/10mL | 40 | $39.84 | $4.869 | ● Active | CMS + PDAC |
| 70121-1653-01 | Triamcinolone Acetonide 400 mg/10mL INJECTION, SUSPENSION | Amneal | 1 VIAL, MULTI-DOSE in 1 CARTON (70121-1653... | 400 mg/10mL | 40 | $39.84 | $4.869 | ● Active | CMS + PDAC |
| 70121-1655-01 | Triamcinolone Acetonide 400 mg/10mL INJECTION, SUSPENSION | Amneal | 1 VIAL, MULTI-DOSE in 1 CARTON (70121-1655... | 400 mg/10mL | 40 | $39.84 | $4.869 | ● Active | CMS + PDAC |
| 81298-5783-03 | Triamcinolone Acetonide 40 mg/mL SUSPENSION | Long | 1 VIAL, MULTI-DOSE in 1 CARTON (81298-5783... | 40 mg/mL | 40 | $39.84 | $4.869 | ● Active | CMS + PDAC |
| 00703-0243-01 | Triamcinolone Acetonide 40 mg/mL INJECTION, SUSPENSION | Teva | 1 VIAL, MULTI-DOSE in 1 CARTON (0703-0243-... | 40 mg/mL | 20 | $19.92 | $6.328 | ● Active | CMS + PDAC |
| 16714-0140-01 | Triamcinolone Acetonide 200 mg/5mL INJECTION, SUSPENSION | NorthStar | 1 VIAL in 1 CARTON (16714-140-01) / 5 mL... | 200 mg/5mL | 20 | $19.92 | $6.328 | ● Active | CMS + PDAC |
| 43598-0694-11 | TRIAMCINOLONE ACETONIDE 200 mg/5mL INJECTION, SUSPENSION | Dr. | 1 VIAL, MULTI-DOSE in 1 CARTON (43598-694-... | 200 mg/5mL | 20 | $19.92 | $6.328 | ● Active | CMS + PDAC |
| 70121-1168-01 | Triamcinolone Acetonide 200 mg/5mL INJECTION, SUSPENSION | Amneal | 1 VIAL, MULTI-DOSE in 1 CARTON (70121-1168... | 200 mg/5mL | 20 | $19.92 | $6.328 | ● Active | CMS + PDAC |
| 70121-1652-01 | Triamcinolone Acetonide 200 mg/5mL INJECTION, SUSPENSION | Amneal | 1 VIAL, MULTI-DOSE in 1 CARTON (70121-1652... | 200 mg/5mL | 20 | $19.92 | $6.328 | ● Active | CMS + PDAC |
| 70121-1654-01 | Triamcinolone Acetonide 200 mg/5mL INJECTION, SUSPENSION | Amneal | 1 VIAL, MULTI-DOSE in 1 CARTON (70121-1654... | 200 mg/5mL | 20 | $19.92 | $6.328 | ● Active | CMS + PDAC |
| 81298-5785-03 | Triamcinolone Acetonide 40 mg/mL SUSPENSION | Long | 1 VIAL, MULTI-DOSE in 1 CARTON (81298-5785... | 40 mg/mL | 20 | $19.92 | $6.328 | ● Active | CMS + PDAC |
| 55150-0384-01 | Triamcinolone Acetonide 40 mg/mL INJECTION, SUSPENSION | Eugia | 1 VIAL, MULTI-DOSE in 1 CARTON (55150-384-... | 40 mg/mL | 20 | $19.92 | $6.671 | ● Active | CMS + PDAC |
| 00003-0293-28 | KENALOG-40 TRIAMCINOLONE ACETONIDE 40 mg/mL INJECTION, SUSPENSION | E.R. | 1 VIAL, MULTI-DOSE in 1 CARTON (0003-0293-... | 40 mg/mL | 40 | $39.84 | $6.784 | ● Active | CMS + PDAC |
| 00703-0241-01 | Triamcinolone Acetonide 40 mg/mL INJECTION, SUSPENSION | Teva | 1 VIAL, SINGLE-DOSE in 1 CARTON (0703-0241... | 40 mg/mL | 4 | $3.98 | $6.990 | ● Active | CMS + PDAC |
| 70121-1049-02 | Triamcinolone Acetonide 40 mg/mL INJECTION, SUSPENSION | Amneal | 1 VIAL in 1 CARTON (70121-1049-2) / 1 mL... | 40 mg/mL | 4 | $3.98 | $6.990 | ● Active | CMS + PDAC |
| 70121-1651-01 | Triamcinolone Acetonide 40 mg/mL INJECTION, SUSPENSION | Amneal | 1 VIAL in 1 CARTON (70121-1651-1) / 1 mL... | 40 mg/mL | 4 | $3.98 | $6.990 | ● Active | CMS + PDAC |
| 70121-1657-01 | Triamcinolone Acetonide 40 mg/mL INJECTION, SUSPENSION | Amneal | 1 VIAL in 1 CARTON (70121-1657-1) / 1 mL... | 40 mg/mL | 4 | $3.98 | $6.990 | ● Active | CMS + PDAC |
| 00003-0293-05 | KENALOG-40 TRIAMCINOLONE ACETONIDE 40 mg/mL INJECTION, SUSPENSION | E.R. | 1 VIAL, SINGLE-DOSE in 1 CARTON (0003-0293... | 40 mg/mL | 4 | $3.98 | $9.001 | ● Active | CMS + PDAC |
| 00003-0293-20 | KENALOG-40 TRIAMCINOLONE ACETONIDE 40 mg/mL INJECTION, SUSPENSION | E.R. | 1 VIAL, MULTI-DOSE in 1 CARTON (0003-0293-... | 40 mg/mL | 20 | $19.92 | $9.165 | ● Active | CMS + PDAC |
| 00003-0315-05 | KENALOG-80 TRIAMCINOLONE ACETONIDE 80 mg/mL INJECTION, SUSPENSION | E.R. | 1 VIAL, SINGLE-DOSE in 1 CARTON (0003-0315... | 80 mg/mL | 8 | $7.97 | $17.844 | ● Active | CMS ASP |
| 00003-0315-20 | KENALOG-80 TRIAMCINOLONE ACETONIDE 80 mg/mL INJECTION, SUSPENSION | E.R. | 1 VIAL, MULTI-DOSE in 1 CARTON (0003-0315-... | 80 mg/mL | 40 | $39.84 | — | ● Active | CMS ASP |
| 43598-0676-11 | TRIAMCINOLONE ACETONIDE 10 mg/mL INJECTION, SUSPENSION | Dr. | 1 VIAL, MULTI-DOSE in 1 CARTON (43598-676-... | 10 mg/mL | 5 | $4.98 | — | ● Active | CMS + PDAC |
| 50090-0256-00 | KENALOG-40 TRIAMCINOLONE ACETONIDE 40 mg/mL INJECTION, SUSPENSION | A-S | 1 VIAL, MULTI-DOSE in 1 CARTON (50090-0256... | 40 mg/mL | 20 | $19.92 | — | ● Active | CMS ASP |
| 50090-0295-01 | KENALOG-10 TRIAMCINOLONE ACETONIDE 10 mg/mL INJECTION, SUSPENSION | A-S | 1 VIAL, MULTI-DOSE in 1 CARTON (50090-0295... | 10 mg/mL | 5 | $4.98 | — | ● Active | CMS ASP |
| 50090-0819-00 | KENALOG-40 TRIAMCINOLONE ACETONIDE 40 mg/mL INJECTION, SUSPENSION | A-S | 1 VIAL, MULTI-DOSE in 1 CARTON (50090-0819... | 40 mg/mL | 40 | $39.84 | — | ● Active | CMS ASP |
| 50090-2360-00 | KENALOG-40 TRIAMCINOLONE ACETONIDE 40 mg/mL INJECTION, SUSPENSION | A-S | 1 VIAL, SINGLE-DOSE in 1 CARTON (50090-236... | 40 mg/mL | 4 | $3.98 | — | ● Active | CMS ASP |
| 67457-0621-02 | Triamcinolone Acetonide | Mylan | — | — | 4 | $3.98 | — | — | CMS ASP |
| 67457-0622-05 | Triamcinolone Acetonide | Mylan | — | — | 20 | $19.92 | — | — | CMS ASP |
| 67457-0622-99 | TRIAMCINOLONE ACETONIDE 200 mg/5mL INJECTION, SUSPENSION | Mylan | 25 VIAL, MULTI-DOSE in 1 CARTON (67457-622... | 200 mg/5mL | 500 | $498.00 | — | ● Active | CMS + PDAC |
| 67457-0623-10 | Triamcinolone Acetonide | Mylan | — | — | 40 | $39.84 | — | — | CMS ASP |
| 67457-0623-99 | TRIAMCINOLONE ACETONIDE 400 mg/10mL INJECTION, SUSPENSION | Mylan | 25 VIAL, MULTI-DOSE in 1 CARTON (67457-623... | 400 mg/10mL | 1,000 | $996.00 | — | ● Active | CMS + PDAC |
| 71266-1080-02 | TRIAMCINOLONE ACETONIDE SDV 40 MG/1 ML | Unknown | — | — | 4 | $3.98 | — | — | PDAC |
| 76420-0085-01 | KENALOG-40 TRIAMCINOLONE ACETONIDE 40 mg/mL INJECTION, SUSPENSION | Asclemed | 1 mL in 1 VIAL, SINGLE-DOSE (76420-085-01) | 40 mg/mL | 4 | $3.98 | — | ● Active | PDAC |
| 72603-0108-01 | TRIAMCINOLONE ACETONIDE (LATEX-FREE) 40 MG/1 ML | Unknown | — | — | 4 | $3.98 | — | — | PDAC |
| 72603-0202-01 | TRIAMCINOLONE ACETONIDE (LATEX-FREE) 40 MG/1 ML | Unknown | — | — | 4 | $3.98 | — | — | PDAC |
| 72603-0401-01 | TRIAMCINOLONE ACETONIDE (LATEX-FREE) 40 MG/1 ML | Unknown | — | — | 4 | $3.98 | — | — | PDAC |
| 00065-0543-01 | TRIESENCE 40 MG/ML | Unknown | — | — | 4 | $3.98 | — | — | 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
$2.92M
Claims
813,059
Beneficiaries
728,870
Spend / beneficiary
$4.01
Spend / claim
$3.59
Trend by period
Where J3301 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #294 of 824
#289
ERIBULIN MESYLATE* J9179
$3.09M
#290
OASIS ULTRA Q4124
$3.07M
#291
THYROGEN J3240
$3.03M
#292
DOXIL* Q2050
$3M
#293
GRAFIX STRAVIX PRIME... Q4133
$2.95M
#294
KENALOG-10* J3301
$2.92M
#295
AVSOLA Q5121
$2.89M
#296
YEZTUGO(J0738) J0738
$2.88M
#297
MYCOPHENOLIC ACID* J7518
$2.87M
#298
XCELL AMNIO MATRIX P... Q4280
$2.85M
#299
ZIIHERA J9276
$2.83M
Total claims — #1 of 824
#1
KENALOG-10* J3301
813,059
#2
DEXAMETHASONE SODIUM... J1100
455,323
#3
KETOROLAC TROMETHAMI... J1885
440,857
#4
DEPO-MEDROL* J1010
417,801
#5
CYANOCOBALAMIN INJEC... J3420
343,052
#6
FLUZONE HIGH-DOSE * 90662
321,400
#7
IODIXANOL(Q9967)* Q9967
289,727
#8
PROLIA* J0897
260,340
#9
COMIRNATY * 91320
259,929
#10
VABYSMO J2777
242,296
#11
PREVNAR 20 90677
225,730
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) | $2.92M | 728,870 | 813,059 | $4.01 | $3.59 |
| 2025 (Q1-Q4) | $15.66M | 2,224,990 | 3,712,172 | $7.04 | $4.22 |
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
$16.01M
Medicare paid
$11.5M
Submitted services
19,792,004
Denial rate
6.7%
Allowed / service
$0.87
Submitted charges
$197.42M
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 J3301 is utilized CMS · BY PROVIDER · 2024
Medicare Part B services for this code by the rendering provider's state — 17,037,070 services across 57 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 J3301
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
NDC products by labeler
🗃️ 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)
48 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.
❓ J3301 billing FAQ
What is HCPCS code J3301?
J3301 is a HCPCS Level II J-code used to bill Injection, triamcinolone acetonide, not otherwise specified, 10 mg under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J3301?
One unit of J3301 represents 10 MG. Report the number of units equal to the dose administered divided by 10 MG.
How many units of J3301 should I bill?
Divide the dose administered by the code's unit size (10 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 J3301?
The Medicare Part B payment limit is $0.996 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $0.976 per unit. Payment limits are revised quarterly.
Which NDCs bill under J3301?
48 NDCs currently map to J3301 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 J3301 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.