Injectafer (ferric carboxymaltose) — J1439

Injectafer and the IV iron class

Injectafer (ferric carboxymaltose) bills under J1439, 1 mg per billing unit, from American Regent. It is the first drug on this site with more than one vial size — four — and the 750 mg labeled dose is exactly one of them. Five other IV iron agents compete in the same drug class under their own HCPCS codes, and none of them is a biosimilar of Injectafer or of each other.

Injectafer carries a boxed warning for symptomatic hypophosphatemia, which can cause severe, prolonged hypophosphatemia associated with serious outcomes including hospitalization, osteomalacia and fractures requiring clinical intervention. Check serum phosphate before a repeat course within three months or in patients at risk, and correct pre-existing hypophosphatemia first.

Vials and NDCs

Four sizes means a dose can usually be drawn more than one way. The billing-units calculator draws the fewest vials that cover the dose, tied to least waste, the same rule a single-vial drug already followed without needing to say so.

This reference does not pick a preferred iron product on clinical grounds. For Injectafer, the visit count against Venofer and the 11-of-16 payer step edit decide the choice more than the per-mg rate does.

Injectafer dosing

Every regimen is a course, not a repeating interval: two doses at least 7 days apart (or one weight-based dose up to 1,000 mg), repeated only if iron deficiency recurs. Which regimen applies depends on body weight and indication.

Heart failure: label Table 1

The heart-failure regimen is set by body weight crossed with hemoglobin — not by a single number. The label's Table 1, in full:

After Week 6, maintenance is 500 mg at weeks 12, 24 and 36 if ferritin is under 100 ng/mL, or 100–300 ng/mL with TSAT under 20%.

Pre-treatment documentation

• Document ferritin and transferrin saturation within the prior 90 days — 10 of the 16 payers in the Clearance corpus name a ferritin threshold and 7 a TSAT threshold.
• Document oral iron failure or intolerance for the iron-deficiency anemia indication; 15 of the 16 payers write it into a rule, and it is where prior authorization is refused most often.
• Correct pre-existing hypophosphatemia, and for any repeat course within three months check serum phosphate first — the label's boxed warning. No payer in the corpus asks for a phosphate level; it is a label requirement, not a coverage one.
• For the heart-failure indication, document NYHA class II or III and the hemoglobin that sets the Table 1 dose; pair E61.1 with a billable I50 child code such as I50.22, never the bare I50.2.

Need the units for a patient's dose? Convert dose to J1439 billing units →

Injectafer billing reference

HCPCS

J1439 bills 1 mg per unit. A 750 mg dose is 750 units; a 1,000 mg single dose is 1,000 units; a full two-dose course totals 1,500 units.

NDC

Four package sizes, each its own NDC — see the vial table in Drug & products above. Confirm which vial (or combination of vials) the encounter note describes before submitting; unlike a single-size drug, the NDC on the claim is a real choice here, not a formality.

Administration

Administration is a decision, not a fixed code: documented infusion time decides whether it is a push or an infusion. CPT 96374–96376 and CPT 96365–96366 carry the complete code definitions.

Modifiers

JZ — required when no drug is discarded. JW — required for documented waste.

The 750 mg course dose and the 1,000 mg single dose each draw one whole vial with nothing left over, so JZ is the norm on the adult regimens. The under-50 kg pediatric dose is the routine source of waste on this drug — see the worked vial example in the billing-units calculator for the JW-vs-JZ choice.

Full unit, vial and modifier math for any dose: calculate Injectafer billing units →

Claim form

CMS-1500 / 837P field map for a separately payable J1439 claim.

Injectafer coverage

The Clearance corpus carries 16 payers and 181 rules for ferric carboxymaltose. 11 of those 16 payers require documented failure of another IV iron product before they cover Injectafer — a real step edit, not the exception a specialty infusion might suggest. The other 5 gate on oral iron failure and lab thresholds only.

• 14 of 16 commercial payer policy sets require prior authorization; 2 do not say clearly, so confirm those on the call
• 15 of 16 payers require documented oral iron failure or intolerance before ferric carboxymaltose is covered.
• 10 of 16 payers set a ferritin threshold and 7 a TSAT threshold in their prerequisite rules; no payer asks for a serum phosphate level — that check is a label requirement, not a coverage one.
• 8 rules set a quantity limit, 5 require reauthorization and 2 payers carry site-of-care language across the whole IV-iron class.

ICD-10-CM by indication

Verified against the NLM Clinical Table Search Service on 2026-09-19. Chart documentation decides which subtype applies, the same way it decides the 15-minute line between 96374 and 96365.

Check the patient’s actual policy: See Injectafer coverage by payer →

Full FDA-indicated Medicare reference: Medicare covered diagnoses for Injectafer →

Injectafer cost & financial access

Medicare ASP+6%: $1.121 / 1 mg · $840.75 / 750 mg. Administration (96374) allows $37.74 more, so the reference claim — a 750 mg dose plus 96374 — allows $878.49 total.

The two-dose course allows $1,681.50 for the drug alone. The single-dose alternative (1,000 mg plus 96374) allows $1,158.74.

At 20% coinsurance with the $283 Part B deductible already met, the patient owes $175.70 of the 750 mg reference claim, or $231.75 of the single-dose alternative. Commercial plans pay a contracted rate that varies by payer and state; 37 of 37 payer price files in this site's data carry a J1439 rate.

Per 1,000 mg of iron, Injectafer costs about 5× Venofer — see the IV iron class table above. Venofer's course takes five visits to Injectafer's one or two, which is the honest way to state that trade: the visit count is what the cheaper drug saves, not the total course cost in every case.

Patient cost

Patient responsibility = payer allowed rate − benefits adjustment − assistance. Confirm which regimen (course vs. single dose) the encounter reflects before estimating — the two allowed amounts differ by nearly $300.

Calculate an Injectafer patient estimate →

Copay & financial assistance

The Injectafer Savings Program caps a commercially insured patient at $50 per dose, up to four doses a year — but it pays only the drug, never the push or the visit, and it excludes Medicare, Medicaid, TRICARE and any federal plan.

Injectafer Patient Assistance Program ships Injectafer free to the provider for uninsured patients at or under 500% of the federal poverty level, with no stated cap.

See current Injectafer assistance programs →

Common Injectafer errors & fixes