HCPCS Level II J0750: Emtricitabine/Tenofovir for HIV PrEP

HCPCS Level II code J0750 represents the FDA‑approved prescription combination of emtricitabine 200 mg and tenofovir disoproxil fumarate 300 mg, supplied orally for HIV pre-exposure prophylaxis (PrEP); the service type is oral prescription medication for HIV prevention, typically provided in outpatient clinics, primary care offices, sexual health clinics, and specialty infectious disease practices where clinicians prescribe and dispense or facilitate access to PrEP medications.

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 HIV-negative adult seeking HIV pre-exposure prophylaxis (PrEP) after a documented potential exposure risk (e.g., partner with HIV, sexual exposure, or injection drug use). The clinical workflow begins with a preventive medicine or infectious disease visit where the provider documents risk assessment, obtains baseline laboratory tests (HIV antigen/antibody, renal function — serum creatinine, hepatitis B surface antigen, pregnancy test if applicable, and STI screening), counsels on adherence and safer-sex practices, and prescribes the FDA-approved PrEP oral medication combination J0750 (emtricitabine 200 mg / tenofovir disoproxil fumarate 300 mg). Medication is dispensed or provided per facility policy; follow-up visits are scheduled at approximately 1 month after initiation and every 3 months thereafter for repeat HIV testing, renal monitoring, and STI screening. Typical sites of service include outpatient primary care clinics, sexually transmitted infection clinics, specialty infectious disease or HIV prevention clinics, and community-based health centers. The typical patient scenario includes documentation of negative baseline HIV test, documented indication for PrEP, patient education, and a written prescription or medication provision coded with J0750 when the drug is billed under HCPCS Level II (for example, when supplied by a clinic or covered under medical benefit).

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes	Common for routine PrEP follow-up visits including HIV testing review and renal monitoring.
`99214`	Office or other outpatient visit for established patient, typically 25 minutes	Used when counseling, risk assessment, and medication management require moderate complexity.
`87880`	Infectious agent antigen detection by immunoassay with direct optical observation; HIV-1/HIV-2, single step method (e.g., rapid test)	Performed at baseline and follow-up to confirm HIV-negative status before and during PrEP.
`36415`	Collection of venous blood by venipuncture	Performed for baseline and monitoring labs such as serum creatinine, hepatitis B testing, and HIV serology.
`87110`	Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates	Used when STI screening or symptomatic evaluations require culture (site dependent).

Related Modifiers

6 rows

Modifier	Description	When to Use
52	Modifier ‑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…
53	Modifier 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…
62	Modifier 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…
78	CPT 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…
80	CPT® 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…
82	Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…	- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207Q00000X	Family Medicine Physician	Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
208000000X	Pediatrics Physician	A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
207RG0100X	Gastroenterology Physician	An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This…
207L00000X	Anesthesiology Physician	An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
363LP0808X	Psychiatric/Mental Health Nurse Practitioner	Physician Assistants & Advanced Practice Nursing Providers · Nurse Practitioner
332G00000X	Eye Bank	An eye bank procures and distributes eyes for transplant, education and research. To promote patient safety, donated eyes and donor medial histories a…
2251X0800X	Orthopedic Physical Therapist	A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Orthopaedic Physical Therapy, who has…
261QS0132X	Ophthalmologic Surgery Clinic/Center	Ambulatory Health Care Facilities · Clinic/Center

Related ICD-10-CM Codes

25 rows

ICD-10-CM Code	Description
A64	Unspecified sexually transmitted disease
B20	Human immunodeficiency virus [HIV] disease
F10.20	Alcohol dependence, uncomplicated
F17.210	Nicotine dependence, cigarettes, uncomplicated
R68.83	Chills (without fever)
R68.89	Other general symptoms and signs
R75	Inconclusive laboratory evidence of human immunodeficiency virus [HIV]
Z01.42	Encounter for cervical smear to confirm findings of recent normal smear following initial abnormal smear
Z11.4	Encounter for screening for human immunodeficiency virus [HIV]
Z11.59	Encounter for screening for other viral diseases

Showing 1–10 of 25

Related Payer Policy Updates

Specialty: Hematology/Oncology1 / 3

4 rows

Policy	Payer	Effective Date
Epithelial Cell Cytology in Breast Cancer Risk Assessment	Oscar Health	2026-10-01
Chemotherapy Observation or Inpatient Hospitalization (for New Mexico Only)	UnitedHealthcare	2026-08-01
Antibody-Drug Conjugates	Premera Bluecross	2026-08-01
Umbilical Cord Blood Harvesting and Storage for Future Use (for Indiana Only)	UnitedHealthcare	2026-08-01

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

Frequently Asked Questions

References

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.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.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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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes	Common for routine PrEP follow-up visits including HIV testing review and renal monitoring.
`99214`	Office or other outpatient visit for established patient, typically 25 minutes	Used when counseling, risk assessment, and medication management require moderate complexity.
`87880`	Infectious agent antigen detection by immunoassay with direct optical observation; HIV-1/HIV-2, single step method (e.g., rapid test)	Performed at baseline and follow-up to confirm HIV-negative status before and during PrEP.
`36415`	Collection of venous blood by venipuncture	Performed for baseline and monitoring labs such as serum creatinine, hepatitis B testing, and HIV serology.
`87110`	Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates	Used when STI screening or symptomatic evaluations require culture (site dependent).

Related Modifiers

6 rows

Modifier	Description	When to Use
52	Modifier ‑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…
53	Modifier 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…
62	Modifier 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…
78	CPT 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…
80	CPT® 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…
82	Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…	- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207Q00000X	Family Medicine Physician	Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
208000000X	Pediatrics Physician	A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
207RG0100X	Gastroenterology Physician	An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This…
207L00000X	Anesthesiology Physician	An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
363LP0808X	Psychiatric/Mental Health Nurse Practitioner	Physician Assistants & Advanced Practice Nursing Providers · Nurse Practitioner
332G00000X	Eye Bank	An eye bank procures and distributes eyes for transplant, education and research. To promote patient safety, donated eyes and donor medial histories a…
2251X0800X	Orthopedic Physical Therapist	A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Orthopaedic Physical Therapy, who has…
261QS0132X	Ophthalmologic Surgery Clinic/Center	Ambulatory Health Care Facilities · Clinic/Center

Related ICD-10-CM Codes

25 rows

ICD-10-CM Code	Description
A64	Unspecified sexually transmitted disease
B20	Human immunodeficiency virus [HIV] disease
F10.20	Alcohol dependence, uncomplicated
F17.210	Nicotine dependence, cigarettes, uncomplicated
R68.83	Chills (without fever)
R68.89	Other general symptoms and signs
R75	Inconclusive laboratory evidence of human immunodeficiency virus [HIV]
Z01.42	Encounter for cervical smear to confirm findings of recent normal smear following initial abnormal smear
Z11.4	Encounter for screening for human immunodeficiency virus [HIV]
Z11.59	Encounter for screening for other viral diseases

Showing 1–10 of 25

Related Payer Policy Updates

Specialty: Hematology/Oncology1 / 3

4 rows

Policy	Payer	Effective Date
Epithelial Cell Cytology in Breast Cancer Risk Assessment	Oscar Health	2026-10-01
Chemotherapy Observation or Inpatient Hospitalization (for New Mexico Only)	UnitedHealthcare	2026-08-01
Antibody-Drug Conjugates	Premera Bluecross	2026-08-01
Umbilical Cord Blood Harvesting and Storage for Future Use (for Indiana Only)	UnitedHealthcare	2026-08-01

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

Frequently Asked Questions

References

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

HCPCS Level II J0750: Emtricitabine/Tenofovir for HIV PrEP

Sign up for hcpcs J0750 policy alerts

HCPCS Level II J0750: Emtricitabine/Tenofovir for HIV PrEP

Sign up for hcpcs J0750 policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

What does HCPCS code J0750 represent and when is it used?

In what clinical settings and workflow is J0750 typically provided?

Which related CPT and lab codes are commonly associated with billing for J0750 and PrEP care?

What modifiers are relevant for J0750 claims and when are they applied?

Which ICD‑10 diagnosis codes are commonly used with J0750 for PrEP visits?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

What does HCPCS code J0750 represent and when is it used?

In what clinical settings and workflow is J0750 typically provided?

Which related CPT and lab codes are commonly associated with billing for J0750 and PrEP care?

What modifiers are relevant for J0750 claims and when are they applied?

Which ICD‑10 diagnosis codes are commonly used with J0750 for PrEP visits?

References