HCPCS Level II · Drugs administered other than oral method
J0738Injection, lenacapavir, 1 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)
✓ Active
Source: CMS HCPCS quarterly update, October 2026. Page updated September 29, 2026.
About J0738
J0738 is an HCPCS Level II code in the J series (drugs administered other than oral method), describing injection, lenacapavir, 1 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv).
It was added to HCPCS effective 10/01/2025.
Its Medicare coverage code is "D", meaning special Medicare coverage instructions apply.
Details
- Short description
- Hiv prep, inj, lenacapavir
- Date added
- 10/01/2025
- Action effective
- 10/01/2025
- BETOS
- O1E
Related J07xx codes
- J0701Injection, cefepime hydrochloride (baxter), not therapeutically equivalent to maxipime, 500 mg
- J0702Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg
- J0703Injection, cefepime hydrochloride (b braun), not therapeutically equivalent to maxipime, 500 mg
- J0706Injection, caffeine citrate, 5 mg
- J0712Injection, ceftaroline fosamil, 10 mg
- J0713Injection, ceftazidime, per 500 mg
- J0714Injection, ceftazidime and avibactam, 0.5 g/0.125 g
- J0716Injection, centruroides immune f(ab)2, up to 120 milligrams
- J0717Injection, certolizumab pegol, 1 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)
- J0720Injection, chloramphenicol sodium succinate, up to 1 gm
- J0725Injection, chorionic gonadotropin, per 1,000 usp units
- J0735Injection, clonidine hydrochloride, 1 mg
Common questions about J0738
Is HCPCS J0738 still valid?
- Yes. J0738 is active in the CMS October 2026 HCPCS file.
Does Medicare cover J0738?
- Its coverage code is "D": special Medicare coverage instructions apply. Check the local coverage determination for your region.