J1438 HCPCS Level II code: Injection, etanercept, 25 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self…
J1438 is the HCPCS code for “Injection, etanercept, 25 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)” in CMS’s October 2026 release, in effect from Oct 1, 2026.
Official description
J1438Injection, etanercept, 25 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)
Short description: Etanercept injection
HCPCS · United States
Medicare details
The indicators CMS publishes with J1438 in its October 2026 file. They describe Medicare’s handling, not another payer’s.
- Medicare coverage
- Special coverage instructions apply
- Medicare pricing
- Drugs
- ASC
- Approved for ambulatory surgical centers
- Type of service
- Medical care; Lump sum purchase of DME, prosthetics, orthotics
- BETOS category
- Other drugs
- Added
- Jan 1, 2000
Where J1438 sits
- 1J codesDrugs administered other than orally
- 2Active code J1438Injection, etanercept, 25 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)
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 J1438 mean?
J1438 is the HCPCS code for “Injection, etanercept, 25 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)” in CMS’s HCPCS Level II October 2026 release.
Does Medicare cover J1438?
CMS lists J1438’s Medicare coverage as “Special coverage instructions apply” and its pricing as “Drugs”. 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 J1438
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