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    v1.0.28
    OpenPayerBilling CodesDrugs Administered Other than Oral MethodHCPCS hcpcs-j0578-buprenorphine-extended-release-brixadi-7-28-days
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    HCPCS Level II J0578: Buprenorphine Extended-Release Injection, 7–28 Days

    HCPCS Level II code J0578 represents an injection of buprenorphine extended release (Brixadi) intended to provide greater than 7 days and up to 28 days of therapy, commonly billed for medication-assisted treatment (MAT) of opioid use disorder; the service is administration of a long-acting subcutaneous or intramuscular buprenorphine formulation and the typical site of service is an outpatient clinic, addiction treatment center, or other ambulatory care setting where parenteral long-acting opioid agonist therapy is provided.

    For related coverage guidance, see recent payer policy updates: Epithelial Cell Cytology in Breast Cancer Risk Assessment, Chemotherapy Observation or Inpatient Hospitalization (for New Mexico Only), Antibody-Drug Conjugates.

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is an adult with moderate to severe opioid use disorder receiving monthly extended‑release buprenorphine (Brixadi) injection for maintenance therapy. The patient presents to an outpatient addiction medicine clinic or ambulatory infusion center for medication administration. Pre‑visit workflow includes verification of prior authorization, review of recent urine drug screen and clinical stability, informed consent discussion about risks and benefits, and assessment for contraindications (severe respiratory depression, hypersensitivity). At the visit, a licensed prescriber orders J0578 for a dose covering greater than 7 days and up to 28 days. A registered nurse performs medication preparation per product guidelines, confirms identity and vaccination/allergy history, administers the subcutaneous injection, monitors the patient for a short observation period for injection‑related reactions or precipitated withdrawal, documents lot number and expiration, and updates the patient’s medication administration record. Billing is submitted using HCPCS Level II code J0578 with applicable modifier(s) to indicate circumstances such as multiple procedures, billing exceptions, or discarded drug portions. Typical sites of service are outpatient clinic, ambulatory infusion center, or behavioral health clinic with capability for parenteral medication delivery.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    99213Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutesCommon E/M visit for assessment, counseling, and prescription management before or after J0578 administration.
    96372Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscularMay be used to report the service of administering a parenteral medication when payer policy requires separate reporting for administration in addition to the drug code.
    81002Urinalysis, non‑automated without microscopyPoint‑of‑care urine drug screening commonly performed at initiation and periodically during maintenance therapy.
    80307Drug test(s), presumptive, any number of drug classes; each procedureUsed for urine drug screening panels to monitor for illicit substance use or adherence.
    99406Smoking and tobacco use cessation counseling visit, intermediate, greater than 3 minutes up to 10 minutesBehavioral counseling commonly provided in addiction treatment programs alongside medication therapy.
    G0444Annual depression screening, 15 minutesBehavioral health screening frequently integrated into addiction medicine follow‑up visits.

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    2084P0800XPsychiatry PhysicianA Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, …
    208D00000XGeneral Practice PhysicianA physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
    363L00000XNurse Practitioner(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision mak…
    367A00000XAdvanced Practice MidwifeAdvanced practice midwifery encompasses the independent provision of care during pregnancy, childbirth, and the postpartum period; sexual and reproduc…
    364SM0705XMedical-Surgical Clinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing Providers · Clinical Nurse Specialist
    320800000XMental Illness Community Based Residential Treatment FacilityA home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illnes…
    163WP0809XAdult Psychiatric/Mental Health Registered NurseNursing Service Providers · Registered Nurse
    242T00000XPerfusionistA perfusionist operates extracorporeal circulation and autotransfusion equipment during any medical situation where it is necessary to support or temp…

    Related ICD-10-CM Codes

    25 rows

    ICD-10-CM CodeDescription
    F10.20Alcohol dependence, uncomplicated
    F11.10Opioid abuse, uncomplicated
    F11.120Opioid abuse with intoxication, uncomplicated
    F11.121Opioid abuse with intoxication delirium
    F11.122Opioid abuse with intoxication with perceptual disturbance
    F11.129Opioid abuse with intoxication, unspecified
    F11.14Opioid abuse with opioid-induced mood disorder
    F11.150Opioid abuse with opioid-induced psychotic disorder with delusions
    F11.151Opioid abuse with opioid-induced psychotic disorder with hallucinations
    F11.159Opioid abuse with opioid-induced psychotic disorder, unspecified

    Showing 1–10 of 25

    Related Payer Policy Updates

    Specialty: Hematology/Oncology1 / 3

    4 rows

    PolicyPayerEffective Date
    Epithelial Cell Cytology in Breast Cancer Risk AssessmentOscar Health2026-10-01
    Chemotherapy Observation or Inpatient Hospitalization (for New Mexico Only)UnitedHealthcare2026-08-01
    Antibody-Drug ConjugatesPremera Bluecross2026-08-01
    Umbilical Cord Blood Harvesting and Storage for Future Use (for Indiana Only)UnitedHealthcare2026-08-01

    Related Codes

    HCPCS-J0013-ESKETAMINE-NASAL-SPRAY-1MG

    HCPCS Level II J0013: Esketamine Nasal Spray, 1 mg

    HCPCS-J0120-INJECTION-TETRACYCLINE-250MG

    HCPCS Level II J0120: Injection, Tetracycline, up to 250 mg

    HCPCS-J0121-OMADACYCLINE-INJECTION-1MG

    HCPCS Level II J0121: Omadacycline Injection, 1 mg

    HCPCS-J0122-ERAVACYCLINE-INJECTION-1MG

    HCPCS Level II J0122: Injection, eravacycline, 1 mg

    HCPCS-J0129-ABATACEPT-INJECTION-10MG-PHYSICIAN-SUPERVISED

    HCPCS Level II J0129: Abatacept Injection, 10 mg

    HCPCS-J0130-INJECTION-ABCIXIMAB-10MG

    HCPCS Level II J0130: Injection abciximab, 10 mg

    HCPCS-J0131-INJECTION-ACETAMINOPHEN-10MG-PARENTERAL-ANALGESIC

    HCPCS Level II J0131: Injection, Acetaminophen 10 mg

    HCPCS-J0132-INJECTION-ACETYLCYSTEINE-100MG-INJECTABLE-MEDICATION

    HCPCS Level II J0132: Injection, Acetylcysteine 100 mg

    HCPCS-J0133-ACYCLOVIR-INJECTION-5MG

    HCPCS Level II J0133: Injection, Acyclovir 5 mg

    HCPCS-J0134-ACETAMINOPHEN-INJECTION-FRESENIUS-KABI-10MG

    HCPCS Level II J0134: Injection, Acetaminophen (10 mg)

    Showing 1–10 of 991

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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