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J0738 - HCPCS Code for Hiv prep, inj, lenacapavir (New!) J0738 is a valid 2025 HCPCS code for Injection, lenacapavir, 1 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv) or just “ Hiv prep, inj, lenacapavir ” for short, used in Medical care
CMS Manual System Contractors shall add coverage for Yeztugo (Lenacapavir) HCPCS code J0738 for the injectable (Injection, lenacapavir, 1 mg, FDAapproved prescription, only for use as HIV pre-exposure prophylaxis (not for use as treatment for HIV) effective October 1, 2025
YEZTUGO J Code: J0738 | Cost and Price Yeztugo is a medication aligned with the HCPCS J Code J0738 for billing, pricing, and reimbursement purposes in the United States It is an anti-HIV drug administered via the subcutaneous route and manufactured by Gilead Sciences Inc
Human Immunodeficiency Virus (HIV) Screening and Pre-exposure CMS has determined that Pre-Exposure Prophylaxis (PrEP) using antiretroviral drugs to prevent Human Immunodeficiency Virus (HIV) is covered as an additional preventive service as recommended with a grade of A by the United States Preventive Services Task Force (USPSTF)
Yeztugo: Package Insert Prescribing Information MOA YEZTUGO, a human immunodeficiency virus type 1 (HIV-1) capsid inhibitor, is indicated for pre‑exposure prophylaxis (PrEP) to reduce the risk of sexually acquired HIV-1 in adults and adolescents weighing at least 35 kg who are at risk for HIV-1 acquisition Individuals must have a negative HIV-1 test prior to initiating YEZTUGO (1)
HCPCS Code J0738 - Injection, lenacapavir, 1 mg, fda approve Find detailed information on HCPCS code J0738 for Injection, lenacapavir, 1 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv) Explore coverage, pricing indicators, and service descriptions for J0738
October 2025 HCPCS Updates – New, Revised, and Discontinued HCPCS Codes . . . Use is limited to use in Medicare, Medicaid, or other programs administered by the Centers for Medicare Medicaid Services (CMS) You agree to take all necessary steps to insure that your employees and agents abide by the terms of this agreement