J2251 — Injection, midazolam in 0.9% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg
J2251 is a HCPCS Level II code for injection, midazolam in 0.9% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg. It belongs to the Drugs Administered Other Than Oral Method section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Special coverage instructions apply
There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusE
Excluded from the physician fee schedule by regulation. Payment, where it exists, comes from another fee schedule (drugs via ASP, supplies via DMEPOS, and so on).
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Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
Medically Unlikely Edits — units per day
The most units of J2251 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 22 units MAI 3 — Date of Service Edit: Clinical · Prescribing Information
- outpatient
- 22 units MAI 3 — Date of Service Edit: Clinical · Prescribing Information
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for J2251
- Long descriptor
- Injection, midazolam in 0.9% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg
- Short descriptor
- Inj midazolam in 0.9% nacl
- Added
- January 1, 2023
- BETOS
- O1E
- Pricing indicator
- 51 — Other
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Drugs.
Codes adjacent to J2251
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If J2251 is not quite right, the correct code is very often within a few positions of it.
- J2186Injection, meropenem and vaborbactam, 10mg/10mg (20mg)
- J2210Injection, methylergonovine maleate, up to 0.2 mg
- J2212Injection, methylnaltrexone, 0.1 mg
- J2246Injection, micafungin in sodium (baxter), not therapeutically equivalent to j2248, 1 mg
- J2247Injection, micafungin sodium (par pharm) not thereapeutically equivalent to j2248, 1 mg
- J2248Injection, micafungin sodium, 1 mg
- J2249Injection, remimazolam, 1 mg
- J2250Injection, midazolam hydrochloride, per 1 mg
- J2252Injection, midazolam in 0.8% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg
- J2253Injection, midazolam (seizalam), 1 mg
- J2260Injection, milrinone lactate, 5 mg
- J2265Injection, minocycline hydrochloride, 1 mg
- J2267Injection, mirikizumab-mrkz, 1 mg
- J2270Injection, morphine sulfate, up to 10 mg
- J2271Injection, morphine sulfate, 100mgterminated
- J2272Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg
Questions about J2251
What is HCPCS code J2251?
J2251 is a HCPCS Level II code for injection, midazolam in 0.9% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg. It sits in the Drugs Administered Other Than Oral Method section.
Does Medicare cover J2251?
The CMS HCPCS file marks J2251 as "Special coverage instructions apply". There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
How is J2251 paid under the physician fee schedule?
J2251 carries PFS status code E. Excluded from the physician fee schedule by regulation. Payment, where it exists, comes from another fee schedule (drugs via ASP, supplies via DMEPOS, and so on).