Briumvi (ublituximab-xiiy) — HCPCS J2329

CareCost Estimate · Billing Cheat Sheet

TG Therapeutics 150 mg / 6 mL single-dose vial IV infusion every 24 weeks (after loading) Reviewed: May 2, 2026 ASP: Q2 2026

HCPCS

J2329

1 mg = 1 unit

Maintenance

450 units

450 mg q24wk · 3 vials

Modifier

Required, every claim

Admin CPT

96413/96365

Chemo or therapeutic

Medicare ASP+6%

$68.747

/mg · $30,936.15/450 mg

Codes & NDC

HCPCS	`J2329` — "Inj, ublituximab-xiiy, 1 mg" (permanent, eff. 7/1/2023; pre-2023 used `J3490/J3590`)
NDC	`73150-150-06` (10) / `73150-0150-06` (11) — N4 qualifier — only SKU
Vial	150 mg / 6 mL (25 mg/mL) single-dose
Route	IV infusion (after dilution in 0.9% NaCl)
Benefit	Medical (provider buy-and-bill); not specialty pharmacy

Dosing — three-step regimen

Day 1: 150 mg IV over 4 hr (1 vial)
Day 15: 450 mg IV over 1 hr (3 vials)
Maintenance: 450 mg IV q24wk over 1 hr (3 vials)

Year-1 unit math (new patient)

Day 1 — 150 mg infusion (4 hr): 150 units

Day 15 — 450 mg infusion (1 hr): 450 units

Month 6 — 450 mg maintenance (1 hr): 450 units

Month 12 — 450 mg maintenance (1 hr): 450 units

Total year 1: 1,500 units

Premedication (label-mandated)

Methylprednisolone 100 mg IV ~30 min prior
Antihistamine PO/IV 30–60 min prior
Antipyretic optional (acetaminophen)
Same regimen as Ocrevus IV; bill corticosteroid separately (J2920/J2930)

Administration codes

Code	When
`96413` + `96415` ×3	Day 1 (4-hr chemo IV) — preferred
`96365` + `96366` ×3	Day 1 (4-hr therapeutic IV) — fallback
`96413` alone	Day 15 + maintenance (1-hr chemo IV)
`96365` alone	Day 15 + maintenance (1-hr therapeutic) — fallback
Home admin: S9329/S9379 + 99601/99602

Modifiers

Mod	When
`JZ`	Required every claim (single-dose vial, no waste)
`JW`	Rare — only if ≥1 mg actually wasted
`25`	On E/M when separately identifiable from infusion
`JG` / `TB`	340B — per MAC policy

Common denial: 450 units billed for Day 1. Day 1 = 150 mg/units; Day 15 + maintenance = 450 mg/units.

ICD-10-CM (eff. 10/1/2025)

Code	Briumvi-eligible?
`G35.A` RRMS	Yes (primary)
`G35.C0` SPMS unspecified	Use if relapses present
`G35.C1` Active SPMS	Yes
`G35.D` MS unspecified	Acceptable
`G37.9` CNS demyelinating, NOS	Yes (CIS)
`G35.B0–B2` PPMS family	NO (not FDA-approved)

PPMS denial risk: Briumvi billed with G35.B0/B1/B2 always denies. Switch to Ocrevus (J2350) for PPMS patients.

Payer requirements (May 2026)

Payer	PA	Step / Preference
UHC Medicare Advantage	Yes	Non-preferred (Ocrevus preferred)
Carelon / Anthem	Yes	Step: dimethyl fumarate (commercial) or Kesimpta (Medicaid)
Aetna commercial	Yes	Step edits removed 1/1/2026

UHC existing-utilizer exemption: patients with paid Briumvi claim within 365 days are exempt from step. Pull claim history before submitting PA.

Medicare reimbursement (Q2 2026)

Field	Value
ASP + 6%	$68.747 / mg (effective 4/1 – 6/30/2026)
150 mg dose (Day 1)	$10,312.05 (150 × $68.747)
450 mg dose (D15 + maint)	$30,936.15 (450 × $68.747)
NCD/LCD	None drug-specific; LCD L33394 (generic drug coverage)

Site of care

Setting	POS	Use
Physician office	11	Maintenance only (chair time tight for Day 1)
Ambulatory infusion suite	49	Maintenance ideal; Day 1 workable
Hospital outpatient	19/22	Common for Day 1 (4 hr); UHC/Aetna disfavor for maintenance
Patient home	12	Maintenance only (S9329 + 99601/99602)

Patient assistance

BRIUMVI Patient Support: 1-833-BRIUMVI / 1-833-274-8684
Commercial copay: $0/yr up to $20,000; $550 first / $350 subsequent admin coverage
Quick Start: free drug during PA delays
PAP: uninsured at $100k/1, $125k/2, $150k/3, $175k/4 income
Medicare: verify open foundation funds (PAN, HealthWell, GoodDays)

Disambiguation: Briumvi vs Ocrevus IV: J2329 vs J2350. 450 mg vs 600 mg maintenance. 1-hr vs 3.5-hr infusion. Briumvi NOT FDA-approved for PPMS; Ocrevus IS.

Sources: TG Therapeutics v7 (9/25), FDA label (Feb 2026, BLA 761238), CMS ASP Q2 2026, UHC IAP.001.29, Carelon CC-0227, Aetna CPB 0264. carecostestimate.com/drugs/briumvi