J1 HCPCS Level II modifier: Competitive acquisition program no-pay submission for a prescription number
J1 is a HCPCS Level II modifier: “Competitive acquisition program no-pay submission for a prescription number.” It adds this detail to the code it is reported with.
Official description
J1Competitive acquisition program no-pay submission for a prescription number
Short description: Cap no-pay for prescript num
HCPCS · United States
Medicare details
The indicators CMS publishes with J1 in its October 2026 file. They describe Medicare’s handling, not another payer’s.
- Medicare coverage
- Carrier judgment
- Added
- Jan 1, 2006
Where J1 sits
- 1GroupHCPCS modifiers
- 2Modifier J1Competitive acquisition program no-pay submission for a prescription number
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 J1 mean?
J1 is the HCPCS code for “Competitive acquisition program no-pay submission for a prescription number” in CMS’s HCPCS Level II October 2026 release.
Where is J1 in the HCPCS Level II list?
J1 is listed under Modifiers.
Does Medicare cover J1?
CMS lists J1’s Medicare coverage as “Carrier judgment”. 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 J1
All modifiersHUFunded by child welfare agencyHVFunded state addictions agencyHWFunded by state mental health agencyHXFunded by county/local agencyHYFunded by juvenile justice agencyHZFunded by criminal justice agencyJ2Competitive acquisition program, restocking of emergency drugs after emergency administrationJ3Competitive acquisition program (cap), drug not available through cap as written, reimbursed under average sales price methodologyJ4Dmepos item subject to dmepos competitive bidding program that is furnished by a hospital upon dischargeJ5Off-the-shelf orthotic subject to dmepos competitive bidding program that is furnished as part of a physical therapist or occupational therapist professional serviceJAAdministered intravenouslyJBAdministered subcutaneously