Summary & Overview
HCPCS J2249: Injection, Remimazolam, 1 mg
HCPCS Level II code J2249 denotes a 1 mg injection of remimazolam, a short-acting intravenous benzodiazepine used for procedural sedation and monitored anesthesia care. Nationally, the introduction of remimazolam has clinical significance for short procedures requiring rapid onset and recovery, and it is relevant to facility billing, anesthesia service lines, and pharmacy procurement.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of coverage considerations across major commercial and public payers, standard claim reporting practices for a per-milligram HCPCS drug code, and typical service contexts where the drug is administered. The publication also summarizes billing benchmarks and common modifier usage patterns where data are available.
The piece provides clinical context for when remimazolam is used (procedural sedation, monitored anesthesia care), typical sites of service (hospitals, ambulatory surgical centers), and the implications for coding and billing teams managing injectable anesthesia agents. Data not included in the input are explicitly noted as unavailable.
Billing Code Overview
HCPCS Level II code J2249 represents an injection of remimazolam, 1 mg. This code is used to report administration of the short-acting benzodiazepine agent remimazolam when billed by dose.
Service Type: Drug administration / parenteral sedation agent
Typical Site of Service: Hospital inpatient or outpatient procedural areas, ambulatory surgical centers, and other settings where monitored anesthesia care or procedural sedation is provided
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult undergoing a procedural sedation for a short, minimally invasive diagnostic or therapeutic procedure in an outpatient or ambulatory surgical center, endoscopy suite, or hospital procedural unit. Remimazolam is administered intravenously for procedural sedation due to its rapid onset and short duration. Common scenarios include sedation for colonoscopy, bronchoscopy, minor gynecologic procedures, or short interventional radiology procedures. The clinical workflow typically includes pre-procedure assessment (evaluation of airway, fasting status, medication allergies, and relevant comorbidities), establishment of intravenous access, baseline vital signs and monitoring (pulse oximetry, noninvasive blood pressure, ECG as indicated), administration of J2249 billed per milligram for remimazolam with titration to effect, continuous monitoring during the procedure, and post-anesthesia recovery until discharge criteria are met. Documentation includes indication for sedation, drug name and total milligrams administered, time of administration, responsiveness and airway interventions if any, monitoring records, and discharge instructions.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier / default | Used when no specific modifier applies and the service is reported without special circumstances. |