J7516 — Injection, cyclosporine, 250 mg
J7516 is a HCPCS Level II code for injection, cyclosporine, 250 mg. It belongs to the Drugs Administered Other Than Oral Method section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Carrier judgment
Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
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).
Global period: XXX
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 J7516 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
- 1 unit MAI 3 — Date of Service Edit: Clinical · Clinical: Data
- outpatient
- 4 units MAI 3 — Date of Service Edit: Clinical · Prescribing Information
- DME supplier
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · Published Contractor Policy
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 J7516
- Long descriptor
- Injection, cyclosporine, 250 mg
- Short descriptor
- Inj, cyclosporine 250mg
- Added
- January 1, 2000
- 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 J7516
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If J7516 is not quite right, the correct code is very often within a few positions of it.
- J7508Tacrolimus, extended release, (astagraf xl), oral, 0.1 mg
- J7509Methylprednisolone oral, per 4 mg
- J7510Prednisolone oral, per 5 mg
- J7511Lymphocyte immune globulin, antithymocyte globulin, rabbit, parenteral, 25 mg
- J7512Prednisone, immediate release or delayed release, oral, 1 mg
- J7513Daclizumab, parenteral, 25 mgterminated
- J7514Mycophenolate mofetil (myhibbin), oral suspension, 100 mg
- J7515Cyclosporine, oral, 25 mg
- J7517Mycophenolate mofetil, oral, 250 mg
- J7518Mycophenolic acid, oral, 180 mg
- J7519Injection, mycophenolate mofetil, 10 mg
- J7520Sirolimus, oral, 1 mg
- J7521Tacrolimus, granules, oral suspension, 0.1 mg
- J7525Tacrolimus, parenteral, 5 mg
- J7527Everolimus, oral, 0.25 mg
- J7528Mycophenolate mofetil, for suspension, oral, 100 mg
Questions about J7516
What is HCPCS code J7516?
J7516 is a HCPCS Level II code for injection, cyclosporine, 250 mg. It sits in the Drugs Administered Other Than Oral Method section.
Does Medicare cover J7516?
The CMS HCPCS file marks J7516 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
How is J7516 paid under the physician fee schedule?
J7516 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).