J0799 HCPCS Level II code: Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified
J0799 is the HCPCS code for “Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified” in CMS’s October 2026 release, in effect from Oct 1, 2026.
Official description
J0799Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified
Short description: Hiv prep, fda approved, noc
HCPCS · United States
Medicare details
The indicators CMS publishes with J0799 in its October 2026 file. They describe Medicare’s handling, not another payer’s.
- Medicare coverage
- Special coverage instructions apply
- Medicare pricing
- DMEPOS fee schedule – Carrier priced (e.g., not otherwise classified, individual determination, carrier discretion, gap-filled amounts)
- Type of service
- Medical care
- BETOS category
- Other drugs
- Coverage statute
- 1861(ddd)
- Added
- Jan 2, 2024
Where J0799 sits
- 1J codesDrugs administered other than orally
- 2Active code J0799Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified
Source and release
- Data release
- HCPCS Level II · October 2026
- Effective date
- Oct 1, 2026
- Publisher
- CMS
This page is built from the HCPCS Level II catalog that Vero Codes reads when it suggests codes: Centers for Medicare & Medicaid Services’s October 2026 release, imported from the publisher’s file and checked against it. The description, notes and structured data come from the same record.
Frequently asked questions
What does HCPCS code J0799 mean?
J0799 is the HCPCS code for “Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified” in CMS’s HCPCS Level II October 2026 release.
Does Medicare cover J0799?
CMS lists J0799’s Medicare coverage as “Special coverage instructions apply” and its pricing as “DMEPOS fee schedule – Carrier priced (e.g., not otherwise classified, individual determination, carrier discretion, gap-filled amounts)”. Coverage and payment still depend on the patient, the setting, the documentation and the payer.
Which HCPCS Level II release does this page use?
It uses CMS’s October 2026 release, in effect from Oct 1, 2026 to Dec 31, 2026. It is a reference: confirm the code against the current list and the payer’s rules before you submit it.
Codes beside J0799
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