Summary & Overview
HCPCS Level II J2799: Injection, risperidone (uzedy), 1 mg
HCPCS Level II code J2799 designates a 1 mg unit of injectable risperidone (uzedy). This drug-level code is used when billing for the medication administered as an injection and is relevant across outpatient and ambulatory settings where long-acting or injectable antipsychotic therapies are provided. Nationally, accurate use of this HCPCS Level II code supports appropriate medication billing, inventory tracking, and payer adjudication for injectable psychiatric treatments.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the code’s clinical context and typical sites of service, along with benchmarks and payer coverage considerations where available. The publication summarizes billing guidance, common modifiers used with HCPCS Level II drug codes, and operational implications for ambulatory clinics and behavioral health providers.
The content provides practical reference material for coding staff, revenue cycle teams, and clinical administrators seeking to align medication billing practices with payer requirements and facility workflows. Data not provided in the input—such as specific payer policies, reimbursement rates, associated taxonomies, and ICD-10 pairings—are identified as unavailable.
Billing Code Overview
HCPCS Level II code J2799 represents an injection of risperidone (uzedy), 1 mg. This code covers the drug formulation and unit quantity for administration of risperidone in injectable form.
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Service type: Medication administration (intramuscular or as clinically indicated) delivered as a single-dose injectable formulation
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Typical site of service: Outpatient clinic, physician office, or ambulatory care setting where injectable psychiatric medications are administered
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A 28-year-old adult with schizophrenia and a history of nonadherence to oral antipsychotics presents to an outpatient behavioral health clinic for long-acting injectable antipsychotic therapy. The clinician prescribes risperidone long-acting injection (brand: Uzedy) to improve adherence and symptom control. The patient arrives for a scheduled intramuscular administration; nursing performs pre-injection assessment including confirmation of identity, allergies, current medications, recent symptom status, and measurement of vital signs. The injection is administered in the deltoid or gluteal muscle per product guidance, with documentation of lot number, dose in milligrams, injection site, and patient tolerance. Post-injection observation for immediate adverse reactions is completed prior to discharge. Billing is submitted using the HCPCS Level II code J2799 reported per milligram of risperidone product administered, with any applicable modifiers appended for payer-specific circumstances (for example, when services are reduced, discontinued, performed in a teaching setting, or billed with a bilateral or assistant-at-surgery component). Typical sites of service include outpatient behavioral health clinics, psychiatric clinics, ambulatory infusion centers, and community mental health centers.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier (standard) | Use when no special circumstances apply to the billed service. |