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HCPCS J0741: Injection of Cabotegravir and Rilpivirine, 2mg/3mg

HCPCS Level II code J0741 denotes the unit for injection of cabotegravir and rilpivirine (2mg/3mg), a long-acting two-drug antiretroviral therapy administered intramuscularly. The code is important nationally as it describes billing for a specialty injectable medication used in HIV treatment regimens designed to improve adherence and reduce dosing frequency. Payers and providers use this HCPCS Level II code to report and reimburse the drug component of the injection separate from administration.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of what J0741 represents, payer coverage considerations, typical sites of service, and the clinical context for use. The publication outlines benchmarks and reimbursement context where available, summarizes relevant policy developments affecting coverage of long-acting injectable antiretrovirals, and provides billing considerations tied to service lines. Data not available in the input is noted where applicable.

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Billing Code Overview

HCPCS Level II code J0741 represents the medication injection of cabotegravir and rilpivirine, 2mg/3mg. This code covers the administration unit for the long-acting, two-drug antiretroviral formulation delivered as an intramuscular injection.

Service type: Medication injection (long-acting antiretroviral therapy)
Typical site of service: Outpatient clinic or physician office, specialty infusion center, or other ambulatory care setting where intramuscular injections are administered

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HCPCS J0741: Injection of Cabotegravir and Rilpivirine, 2mg/3mg

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Billing Code Overview

Service type: Medication injection (long-acting antiretroviral therapy)
Typical site of service: Outpatient clinic or physician office, specialty infusion center, or other ambulatory care setting where intramuscular injections are administered

Clinical & Coding Specifications

Clinical Context

A 34-year-old patient with well-controlled HIV-1 infection presents to an outpatient infusion clinic for a scheduled long-acting intramuscular maintenance dose of cabotegravir and rilpivirine. The patient transitioned from daily oral antiretroviral therapy to the injectable regimen after completing the recommended oral lead-in or receiving an initial loading injection series. The clinical workflow includes medication verification and consent, assessment of recent viral load and adherence history, screening for injection site contraindications, documentation of lot numbers and expiration dates, preparation of the combination product J0741, administration as one or two deep intragluteal intramuscular injections per product instructions, observation for immediate adverse reactions for the recommended period, and post-injection counseling. Typical sites of service include outpatient infusion centers, ambulatory clinics, and physician offices with capability for intramuscular injection and observation. Common clinical considerations include ensuring HIV-1 RNA is suppressed before maintenance dosing, monitoring for injection site reactions, and coordinating follow-up dosing appointments.

Coding Specifications

Modifier	Description	When to Use
`00`	Unspecified	Rarely used; not typically applied to drug administration codes but present in modifier list for payer-specific rules
`11`	Office or other outpatient visit	Used when the service is furnished during an outpatient encounter when required by payer reporting (if applicable)
`22`	Increased procedural service	Use when the administration required substantially greater effort or time than usual (document medical necessity)
`52`	Reduced services	Use if a partially reduced injection or truncated supply is delivered and clearly documented
`53`	Discontinued procedure	Use if the injection attempt was started but stopped for patient safety reasons before administration
`62`	Two surgeons	Rare for injection services; use only if two qualified practitioners are required and documented
`78`	Unplanned return to the operating/procedure room	Use if patient requires unplanned return for management of an acute complication after administration
`80`	Assistant surgeon	Rare for injection; use only if an assistant surgeon provided a distinct documented service
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery	Not typical but included when advanced practice clinicians assist in a procedure per payer rules
`JW`	Drug amount discarded/not administered	Use when portion of the vial is discarded and must be reported to meet J-code drug billing rules
`JZ`	No drug administered	Use when drug is ordered but not administered and documentation supports reason
`QK`	Services furnished by a certified registered nurse anesthetist in collaboration	Not typical for IM injection; include only if applicable per facility billing policy
`QX`	Services furnished under the physician's supervision by a PA	Use when a physician bills with a PA furnishing the injection under incident-to rules where allowed
`QY`	Services furnished by a PA under physician supervision	Use per payer rules when PA provides the injection service under required supervision

Taxonomy Code	Specialty	Notes
`364A00000X`	Infectious Disease Physician	Specialty managing complex HIV care and overseeing injectable antiretroviral therapy
`207RG0100X`	Internal Medicine	Primary care clinicians who manage long-term HIV therapy and coordinate injections
`363L00000X`	HIV/AIDS Specialist	Clinicians focused on HIV care delivering or supervising long-acting ART
`177PA0000X`	Physician Assistant	Common provider delivering intramuscular injections in outpatient settings
`163W00000X`	Nurse Practitioner	Advanced practice clinicians who frequently administer and manage injectable ART

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`B20`	Human immunodeficiency virus [HIV] disease	Primary diagnosis indicating HIV infection; long-acting cabotegravir and rilpivirine is indicated for maintenance therapy in virologically suppressed adults with HIV-1
`Z21`	Asymptomatic human immunodeficiency virus [HIV] infection status	Used for patients with HIV who are currently asymptomatic but require ongoing antiretroviral therapy management
`R22.9`	Local swelling, unspecified	Relevant for reporting significant post-injection swelling at the injection site when documented
`T88.1`	Other complications following immunization, not elsewhere classified	Used if the patient experiences a documented adverse reaction to the injection requiring additional care
`Z79.899`	Other long term (current) drug therapy	Used to indicate ongoing chronic medication therapy such as long-acting antiretroviral treatment

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`96372`	Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular	Commonly billed for the intramuscular administration of approved medications when payers require a CPT administration code in addition to drug HCPCS
`96361`	Hydration, each additional hour (for use with main hydration code)	Not typically used for this drug; listed only if prolonged observation with intravenous hydration is required for adverse reaction management
`99070`	Supplies and materials (excepting those usually included with the office visit)	Used to bill expendable supplies associated with administration (e.g., syringes, gloves) when allowed by payer
`99406`	Smoking and tobacco-use cessation counseling visit, intermediate	Example of ancillary counseling code that may be performed during the visit when clinically indicated (billing depends on visit documentation)
`G0123`	Screening for unspecified conditions (example CMS G-code)	Facility-specific observation or monitoring codes may be used per payer rules during the post-injection observation period

Note: If a payer requires specific administration CPT codes in addition to the HCPCS drug code J0741, 96372 is the most directly applicable for intramuscular injection administration in outpatient settings.

Related Codes

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

HCPCS Level II J0013: Esketamine Nasal Spray, 1 mg

HCPCS-J0120-INJECTION-TETRACYCLINE-250MG

HCPCS J0120: Injection, Tetracycline, Up to 250 mg

HCPCS-J0121-OMADACYCLINE-INJECTION-1MG

HCPCS J0121: Omadacycline Injection, 1 mg

HCPCS-J0122-ERAVACYCLINE-INJECTION-1MG

HCPCS J0122: Injection, Eravacycline, 1 mg

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

HCPCS 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 J0131: Injection Acetaminophen, 10 mg

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

HCPCS J0132: Injection, Acetylcysteine 100 mg

HCPCS-J0133-ACYCLOVIR-INJECTION-5MG

HCPCS J0133: Injection, Acyclovir 5 mg

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

HCPCS J0134: Injection, Acetaminophen (Fresenius Kabi), 10 mg

Showing 1–10 of 991

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`00`	Unspecified	Rarely used; not typically applied to drug administration codes but present in modifier list for payer-specific rules
`11`	Office or other outpatient visit	Used when the service is furnished during an outpatient encounter when required by payer reporting (if applicable)
`22`	Increased procedural service	Use when the administration required substantially greater effort or time than usual (document medical necessity)
`52`	Reduced services	Use if a partially reduced injection or truncated supply is delivered and clearly documented
`53`	Discontinued procedure	Use if the injection attempt was started but stopped for patient safety reasons before administration
`62`	Two surgeons	Rare for injection services; use only if two qualified practitioners are required and documented
`78`	Unplanned return to the operating/procedure room	Use if patient requires unplanned return for management of an acute complication after administration
`80`	Assistant surgeon	Rare for injection; use only if an assistant surgeon provided a distinct documented service
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery	Not typical but included when advanced practice clinicians assist in a procedure per payer rules
`JW`	Drug amount discarded/not administered	Use when portion of the vial is discarded and must be reported to meet J-code drug billing rules
`JZ`	No drug administered	Use when drug is ordered but not administered and documentation supports reason
`QK`	Services furnished by a certified registered nurse anesthetist in collaboration	Not typical for IM injection; include only if applicable per facility billing policy
`QX`	Services furnished under the physician's supervision by a PA	Use when a physician bills with a PA furnishing the injection under incident-to rules where allowed
`QY`	Services furnished by a PA under physician supervision	Use per payer rules when PA provides the injection service under required supervision

Taxonomy Code	Specialty	Notes
`364A00000X`	Infectious Disease Physician	Specialty managing complex HIV care and overseeing injectable antiretroviral therapy
`207RG0100X`	Internal Medicine	Primary care clinicians who manage long-term HIV therapy and coordinate injections
`363L00000X`	HIV/AIDS Specialist	Clinicians focused on HIV care delivering or supervising long-acting ART
`177PA0000X`	Physician Assistant	Common provider delivering intramuscular injections in outpatient settings
`163W00000X`	Nurse Practitioner	Advanced practice clinicians who frequently administer and manage injectable ART

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`B20`	Human immunodeficiency virus [HIV] disease	Primary diagnosis indicating HIV infection; long-acting cabotegravir and rilpivirine is indicated for maintenance therapy in virologically suppressed adults with HIV-1
`Z21`	Asymptomatic human immunodeficiency virus [HIV] infection status	Used for patients with HIV who are currently asymptomatic but require ongoing antiretroviral therapy management
`R22.9`	Local swelling, unspecified	Relevant for reporting significant post-injection swelling at the injection site when documented
`T88.1`	Other complications following immunization, not elsewhere classified	Used if the patient experiences a documented adverse reaction to the injection requiring additional care
`Z79.899`	Other long term (current) drug therapy	Used to indicate ongoing chronic medication therapy such as long-acting antiretroviral treatment

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`96372`	Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular	Commonly billed for the intramuscular administration of approved medications when payers require a CPT administration code in addition to drug HCPCS
`96361`	Hydration, each additional hour (for use with main hydration code)	Not typically used for this drug; listed only if prolonged observation with intravenous hydration is required for adverse reaction management
`99070`	Supplies and materials (excepting those usually included with the office visit)	Used to bill expendable supplies associated with administration (e.g., syringes, gloves) when allowed by payer
`99406`	Smoking and tobacco-use cessation counseling visit, intermediate	Example of ancillary counseling code that may be performed during the visit when clinically indicated (billing depends on visit documentation)
`G0123`	Screening for unspecified conditions (example CMS G-code)	Facility-specific observation or monitoring codes may be used per payer rules during the post-injection observation period

Related Codes

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

HCPCS Level II J0013: Esketamine Nasal Spray, 1 mg

HCPCS-J0120-INJECTION-TETRACYCLINE-250MG

HCPCS J0120: Injection, Tetracycline, Up to 250 mg

HCPCS-J0121-OMADACYCLINE-INJECTION-1MG

HCPCS J0121: Omadacycline Injection, 1 mg

HCPCS-J0122-ERAVACYCLINE-INJECTION-1MG

HCPCS J0122: Injection, Eravacycline, 1 mg

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

HCPCS 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 J0131: Injection Acetaminophen, 10 mg

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

HCPCS J0132: Injection, Acetylcysteine 100 mg

HCPCS-J0133-ACYCLOVIR-INJECTION-5MG

HCPCS J0133: Injection, Acyclovir 5 mg

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

HCPCS J0134: Injection, Acetaminophen (Fresenius Kabi), 10 mg

Showing 1–10 of 991

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

HCPCS J0741: Injection of Cabotegravir and Rilpivirine, 2mg/3mg

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HCPCS J0741: Injection of Cabotegravir and Rilpivirine, 2mg/3mg

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

HCPCS J0741: Injection of Cabotegravir and Rilpivirine, 2mg/3mg

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Billing Code Overview

HCPCS J0741: Injection of Cabotegravir and Rilpivirine, 2mg/3mg

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What does HCPCS code J0741 represent and where is it typically used?

Which CPT code should be used for administration when billing J0741?

Which ICD‑10 diagnosis codes are commonly billed with J0741?

What modifiers are relevant when billing J0741 and when should they be considered?

What are the key clinical workflow steps and settings associated with administration of J0741?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What does HCPCS code J0741 represent and where is it typically used?

Which CPT code should be used for administration when billing J0741?

Which ICD‑10 diagnosis codes are commonly billed with J0741?

What modifiers are relevant when billing J0741 and when should they be considered?

What are the key clinical workflow steps and settings associated with administration of J0741?

References