J9256 — Injection, nipocalimab-aahu, 3 mg
J9256 is a HCPCS Level II code for injection, nipocalimab-aahu, 3 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
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The CMS record for J9256
- Long descriptor
- Injection, nipocalimab-aahu, 3 mg
- Short descriptor
- Inj, nipocalimab-aahu, 3 mg
- Added
- January 1, 2026
- 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 J9256
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If J9256 is not quite right, the correct code is very often within a few positions of it.
- J9232Injection, docetaxel (hospira), not therapeutically equivalent to j9171, 1 mg
- J9245Injection, melphalan hydrochloride, not otherwise specified, 50 mg
- J9246Injection, melphalan (evomela), 1 mg
- J9247Injection, melphalan flufenamide, 1mgterminated
- J9248Injection, melphalan (hepzato), 1 mg
- J9249Injection, melphalan (apotex), 1 mg
- J9250Methotrexate sodium, 5 mgterminated
- J9255Injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg
- J9258Injection, paclitaxel protein-bound particles (teva), not therapeutically equivalent to j9264, 1 mgterminated
- J9259Injection, paclitaxel protein-bound particles (american regent), not therapeutically equivalent to j9264, 1 mgterminated
- J9260Injection, methotrexate sodium, 50 mg
- J9261Injection, nelarabine, 50 mg
- J9262Injection, omacetaxine mepesuccinate, 0.01 mg
- J9263Injection, oxaliplatin, 0.5 mg
- J9264Injection, paclitaxel protein-bound particles, 1 mg
- J9265Injection, paclitaxel, 30 mgterminated
Questions about J9256
What is HCPCS code J9256?
J9256 is a HCPCS Level II code for injection, nipocalimab-aahu, 3 mg. It sits in the Drugs Administered Other Than Oral Method section.
Does Medicare cover J9256?
The CMS HCPCS file marks J9256 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 J9256 paid under the physician fee schedule?
J9256 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).