J7626 — Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg
J7626 is a HCPCS Level II code for budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 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 J7626 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
- 2 units MAI 3 — Date of Service Edit: Clinical · Clinical: Data
- outpatient
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
- DME supplier
- 186 units 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 J7626
- Long descriptor
- Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg
- Short descriptor
- Budesonide non-comp unit
- Added
- January 1, 2002
- BETOS
- D1G
- 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 J7626
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If J7626 is not quite right, the correct code is very often within a few positions of it.
- J7611Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg
- J7612Levalbuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 0.5 mg
- J7613Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg
- J7614Levalbuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 0.5 mg
- J7615Levalbuterol, inhalation solution, compounded product, administered through dme, unit dose, 0.5 mg
- J7620Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme
- J7622Beclomethasone, inhalation solution, compounded product, administered through dme, unit dose form, per milligram
- J7624Betamethasone, inhalation solution, compounded product, administered through dme, unit dose form, per milligram
- J7627Budesonide, inhalation solution, compounded product, administered through dme, unit dose form, up to 0.5 mg
- J7628Bitolterol mesylate, inhalation solution, compounded product, administered through dme, concentrated form, per milligram
- J7629Bitolterol mesylate, inhalation solution, compounded product, administered through dme, unit dose form, per milligram
- J7631Cromolyn sodium, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per 10 milligrams
- J7632Cromolyn sodium, inhalation solution, compounded product, administered through dme, unit dose form, per 10 milligrams
- J7633Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, per 0.25 milligram
- J7634Budesonide, inhalation solution, compounded product, administered through dme, concentrated form, per 0.25 milligram
- J7635Atropine, inhalation solution, compounded product, administered through dme, concentrated form, per milligram
Questions about J7626
What is HCPCS code J7626?
J7626 is a HCPCS Level II code for budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg. It sits in the Drugs Administered Other Than Oral Method section.
Does Medicare cover J7626?
The CMS HCPCS file marks J7626 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 J7626 paid under the physician fee schedule?
J7626 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).