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See a sample rate comparisonHCPCS J0739 (Apretude) Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Injection, cabotegravir, 1mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Drugs, Administered by Injection |
| Common Place of Service | 11 - Office None 50 - Federally Qualified Health Center |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J0739 |
| Medicare Payment Limit | $7.02  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 49702-0264-23 - APRETUDE (LATEX-FREE) 200 MG/1 ML |
National average reimbursement for HCPCS J0739 by major payers:
$6.87
$7.96
$6.96
$6.97
Compare published rates across providers.
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HCPCS J0739
5 of 25 sample ratesHigher to lower in this preview
Fayette Community Hospital, Inc., Piedmont Fayette Hospital
Fayette Community Hospital Inc
$15.09Published rateMarion Vamc
$7.84Published rateUch-Mhs, Uchealth Emergency Room - Meadowgrass
Poudre Valley Medical Group LLC
$7.84Published rateCayuga Medical Center
Cayuga Medical Center At Ithaca
$7.30Published rateSsm Health Care St. Louis, Ssm Health St. Mary'S Hospital - St. Louis
Ssm Health Care St. Louis
$3.14Published rate
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See a sample payer proposalHCPCS J0739 vs. Other Drugs, Administered by Injection Codes
The HCPCS J0739 code is part of the Drugs Administered Other than Oral Method services used for Drugs, Administered by Injection. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The HCPCS J0739 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 49702-0264-23-NDC | Moderate | APRETUDE (LATEX-FREE) 200 MG/1 ML |
| J0737-HCPCS | Low | Injection, clindamycin phosphate (baxter), not therapeutically equivalent to j0736, 300 mg |
| J0739-HCPCS | Low | Injection, cabotegravir, 1mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv) |
| J0740-HCPCS | Moderate | Injection, cidofovir, 375 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J0739. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J0739 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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