Nucala (mepolizumab) — HCPCS J2182

CareCost Estimate · Billing Cheat Sheet

GlaxoSmithKline (GSK) 100 mg/mL prefilled syringe / autoinjector / 100 mg lyo vial Subcutaneous q4wk Reviewed: May 3, 2026 ASP: Q2 2026

HCPCS

J2182

1 mg = 1 unit

Std Dose

100 units

100 mg SC q4wk (asthma)

Modifier

Single-dose syringe/pen

Admin CPT

96372

SC therapeutic, non-chemo

Medicare ASP+6%

$31.823

/mg · $3,182.30/100 mg dose

Codes & NDC

HCPCS	`J2182` — "Injection, mepolizumab, 1 mg"
NDC (lyo)	`00173-0881-01` 100 mg lyo vial
NDC (syr)	`00173-0892-01` 100 mg/mL prefilled syringe
NDC (pen)	`00173-0892-02` 100 mg/mL Nucala autoinjector
Storage	Refrigerate 2-8°C; protect from light

Indication-specific dosing

Indication	Dose	Units billed
Severe eos asthma (≥12 yr)	100 mg SC q4wk	100
Pediatric asthma (6-11 yr)	40 mg SC q4wk	40
EGPA (≥6 yr)	300 mg SC q4wk (3 inj)	300
HES (≥12 yr)	300 mg SC q4wk	300
CRSwNP (≥18 yr)	100 mg SC q4wk	100

Eosinophil biomarker

Asthma: blood eos ≥150 cells/µL (severe phenotype documentation)
EGPA/HES: documented eos disease activity
CSU/CRSwNP: no specific eos threshold required
Document baseline eos count + IgE level (when available) in chart

Admin & modifiers

Code	When
`96372`	Therapeutic SC, non-chemo (most common)
`96401`	Some payers accept for biologic SC
NOT 96365/96366 (those are IV) and NOT 96413/96415 (those are chemo)

Self-admin: Autoinjector approved for home use after first clinic dose. After transition, claim shifts to specialty pharmacy / pharmacy benefit.

ICD-10

Code	For
`J45.40-42`	Moderate persistent asthma
`J45.50-52`	Severe persistent asthma
`M30.1`	EGPA / Churg-Strauss
`D72.1`	HES (eosinophilia)
`J33.0-9`	Nasal polyps (CRSwNP)

Anti-IL-5 class comparison

Drug	Code	Route	Eos req
Nucala	J2182	SC q4wk	≥150
Cinqair	J2786	IV q4wk	≥400
Fasenra	J0517	SC q4wk → q8wk	None FDA

Nucala vs Fasenra: Both SC q4wk; Fasenra extends to q8wk after 3 doses. Nucala has 6-yr asthma indication; Fasenra is ≥12 yr.

Payer requirements (May 2026)

Payer	PA	Requirements
UnitedHealthcare	Yes	Eos count + ICS/LABA failure + pulm/allergist
Aetna	Yes	Severe asthma + step therapy from 1 biologic
Cigna	Yes	Specialty pharmacy after first dose
Medicare LCD	Yes	FDA-approved indication + dx

Medicare reimbursement (Q2 2026)

Field	Value
ASP + 6%	$31.823 / mg (eff. 4/1 - 6/30/2026)
100 mg dose	$3,182.30 (asthma std)
300 mg dose	$9,546.90 (EGPA/HES)
Annual (13 doses)	~$41,370 / ~$124,110

Site of care

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

Patient assistance — GSK

Phone: 1-844-468-2225 (1-844-GSK-2BCK)
GSK For You: patient support program
Co-pay card: $0 first dose, ongoing copay support up to $20K/yr (commercial)
GSK Bridges to Access: free for uninsured/underinsured

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

Sources: FDA label (current rev), CMS Q2 2026 ASP, GINA + ACAAI severe asthma + biologics guidance, GSK For You, UHC/Aetna asthma biologic LCDs. carecostestimate.com/drugs/nucala