Fasenra (benralizumab) — HCPCS J0517

CareCost Estimate · Billing Cheat Sheet

AstraZeneca 30 mg/mL prefilled syringe + Fasenra Pen autoinjector SC q4wk × 3 → q8wk maintenance Reviewed: May 3, 2026 ASP: Q2 2026

HCPCS

J0517

1 mg = 1 unit

Std Dose

30 units

30 mg SC, fixed dose

Modifier

Single-dose syringe/pen

Admin CPT

96372

SC therapeutic, non-chemo

Medicare ASP+6%

$163.357

/mg · $4,900.71/30 mg dose

Codes & NDC

HCPCS	`J0517` — "Inj., benralizumab, 1 mg"
NDC (syringe)	`00310-1730-30` 30 mg/mL prefilled syringe
NDC (pen)	`00310-1735-30` 30 mg/mL Fasenra Pen autoinjector
Storage	Refrigerate 2-8°C; protect from light
Class	Anti-IL-5Rα (eos depletion via ADCC)

Dosing — q8wk maintenance

Visit	Date	Dose
1 (loading)	Week 0	30 mg SC
2 (loading)	Week 4	30 mg SC
3 (loading)	Week 8	30 mg SC
4+ (maint.)	q8wk thereafter	30 mg SC

q8wk advantage: 6.5 doses/year vs Nucala/Cinqair 13/year. Patient adherence + lower medical-benefit cost.

Mechanism differentiator

Target: IL-5 receptor alpha (IL-5Rα) on eosinophils
Effect: Direct eos apoptosis via NK-mediated ADCC
Result: Near-complete eos depletion (vs Nucala/Cinqair which bind soluble IL-5)
No FDA eos threshold (but payer LCDs may impose)

Admin & modifiers

Code	When
`96372`	Therapeutic SC, non-chemo (primary)
`96401`	Some payers accept for biologic SC
NOT 96365/96366 (IV) or 96413/96415 (chemo)

Self-admin: First 3 doses clinic-administered; after stable, autoinjector approved for home self-administration. After transition, claim shifts to specialty pharmacy.

ICD-10

Code	For
`J45.40-42`	Mod persistent asthma
`J45.50-52`	Severe persistent asthma
`M30.1`	EGPA / Churg-Strauss (added 2024)

Anti-IL-5 class comparison

Drug	Code	Schedule	Dose/yr
Fasenra	J0517	q4wk × 3 → q8wk	~7
Nucala	J2182	q4wk	~13
Cinqair	J2786	q4wk IV	~13

Fasenra: Lowest doses/yr but highest per-mg ASP. Total annual medical-benefit spend often comparable.

Payer requirements (May 2026)

Payer	PA	Requirements
UnitedHealthcare	Yes	Severe asthma + ICS/LABA failure
Aetna	Yes	May step from another biologic
Cigna	Yes	Spec pharmacy after first 3 doses
Medicare LCD	Yes	FDA-approved indication + dx

Medicare reimbursement (Q2 2026)

Field	Value
ASP + 6%	$163.357 / mg
30 mg dose	$4,900.71
Loading (3 doses)	~$14,702
Annual (loading + 4 maint)	~$34,305 (yr 1) / ~$31,855 (yr 2+)

Site of care

Setting	POS	Notes
Physician office	11	First 3 doses
Patient home	12	After training (autoinjector)
Allergy/pulm clinic	11	Common

Patient assistance — AstraZeneca

Phone: 1-844-FASENRA (1-844-327-3672)
AZ Access 360 / Fasenra Connect: patient navigation
Co-pay program: $0 first dose (commercial)
AZ patient assistance: free for uninsured

Pending SME review. Verify against current AstraZeneca label, payer policies, and CMS ASP file at billing time.

Sources: FDA label (current rev incl. EGPA 2024 approval), CMS Q2 2026 ASP, GINA + ACAAI severe asthma + biologics guidance, AstraZeneca Access 360, UHC/Aetna asthma biologic LCDs. carecostestimate.com/drugs/fasenra