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: Q3 2026
Std Dose
100 units
100 mg SC q4wk (asthma)
Modifier
JZ
Single-dose syringe/pen
Admin CPT
96372
SC therapeutic, non-chemo
Medicare ASP+6%
$32.281
/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 (Q3 2026)
| Field | Value |
|---|
| ASP + 6% | $32.281 / 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
Reviewed by Erin Rose, CareCost Estimate founder. Every figure triangulated against FDA labeling, CMS ASP files & payer policy — see
methodology.