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See a sample rate comparisonHCPCS J2315 (Vivitrol) 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, naltrexone, depot form, 1 mg
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Drugs, Administered by Injection |
| Common Place of Service | 11 - Office 50 - Federally Qualified Health Center |
| Complexity Level | Low |
| ASAM Level | Level 1 - Outpatient Services |
| Care Type | Medication Assisted Treatment |
| Setting | Outpatient |
| Revenue Code | |
| Medicare Fee Schedule | $4.54 per 1 mg (October 2026 ASP) · View Medicare rates for J2315 |
| Medicaid Fee Schedule | $4.525 median of the 8 states in the free preview · View Medicaid rates for J2315 |
| Medicare Payment Limit | $4.24  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS J2315 by major payers:
$4.16
$4.27
$4.49
$4.49
Compare published rates across providers.
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HCPCS J2315
5 of 25 sample ratesHigher to lower in this preview
Dona Hasou
Community Medical Associates Inc
$6.61Published rateMount Carmel Health System
$4.23Published rateSiripanth Nippita
Planned Parenthood Of Greater New York Hcsr
$4.11Published rateHospital Authority Of Valdosta And Lowndes County Georgia, South Georgia Medical Center
Hospital Authority Of Valdosta And Lowndes County Georgia
$4.11Published rateChester River Hospital Center, University Of Maryland Shore Medical Center At Chestertown
Chester River Hospital Center
$3.97Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS J2315 vs. Other Drugs, Administered by Injection Codes
The HCPCS J2315 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 J2315 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 |
|---|---|---|
| J2315-HCPCS | Low | Injection, naltrexone, depot form, 1 mg |
| J2320-HCPCS | Low | Injection, nandrolone decanoate, up to 50 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J2315. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J2315 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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