HCPCS drug code · CMS crosswalk
Actemra J-Code / HCPCS Code
In short
Actemra is billed under HCPCS J3262 — Injection, tocilizumab, 1 mg. One billing unit is 1 mg. CMS's crosswalk lists 3 Actemra NDCs under this code.
Reference
- J3262
- Injection, tocilizumab, 1 mgBilling unit: 1 mg
- Labelers
- Genentech, Inc.
Medicare Part B payment limit
CMS ASP filePayment limit per unit$5.325
Per1 mg
Coinsurance20%
Effective October 1, 2026 through December 31, 2026. Payment allowance limits subject to the ASP methodology are based on 2Q26 ASP data. A payment limit is not a coverage decision; the Medicare contractor decides coverage. CMS ASP pricing files
Actemra units and claim line
Enter the dose given to get the J3262 units and the NDC line for the CMS-1500 and the 837P.
Enter the dose given to build the claim line.
Actemra NDCs and billing units
From CMS’s ASP NDC–HCPCS crosswalk, effective October 1, 2026 through December 31, 2026. Billing units per package are CMS’s figures for the code’s unit.
| NDC (11-digit) | HCPCS | Labeler | Package | Billing units per package |
|---|---|---|---|---|
| 50242-0135-01 | J3262 | Genentech, Inc. | 4 | 80 |
| 50242-0136-01 | J3262 | Genentech, Inc. | 10 | 200 |
| 50242-0137-01 | J3262 | Genentech, Inc. | 20 | 400 |
Actemra: common questions
- What is the J-code for Actemra?
- Actemra is billed under HCPCS J3262 — Injection, tocilizumab, 1 mg. One billing unit is 1 mg. CMS's crosswalk lists 3 Actemra NDCs under this code.
- How many J3262 billing units are in a package of Actemra?
- CMS lists 80 to 400 billing units per package, depending on the NDC, where one unit is 1 mg. Units to report are based on the dose given, not the package.
- Is J3262 a CPT code?
- No. J3262 is a HCPCS Level II code from CMS for the drug itself. Giving it, for example by injection or infusion, is usually reported with a separate CPT administration code.
Other codes for the same drug
- Q0234Injection, tocilizumab-bavi, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation only, 1 mg
- Q0237Injection, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg
- Q0238Injection, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg
- Q0249Injection, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg
- Q5133Injection, tocilizumab-bavi (tofidence), biosimilar, 1 mg
- Q5135Injection, tocilizumab-aazg (tyenne), biosimilar, 1 mg
- Q5156Injection, tocilizumab-anoh (avtozma), biosimilar, 1 mg