Skyrizi (risankizumab-rzaa) — HCPCS J2327

IV induction (J2327) vs SC maintenance (pharmacy benefit) FDA verified 2024 UC label

One drug, two formulations, two completely different billing infrastructures. Get this wrong and the claim is rejected.

Skyrizi exists in two forms. The IV induction formulation (600 mg / 10 mL single-dose vial) is approved only for moderate-to-severe Crohn's disease and ulcerative colitis induction and bills under J2327 on the medical benefit. The subcutaneous formulations (75 mg, 150 mg, 180 mg, and 360 mg autoinjectors / pre-filled cartridges) are used in plaque psoriasis, psoriatic arthritis, and as IBD maintenance from week 12 — these dispense through specialty pharmacy under the pharmacy benefit and are never billed under J2327.

Dosing & induction schedule FDA label revised 2024 (UC approval)

From the FDA prescribing information; same regimen for Crohn's disease and ulcerative colitis.

IV induction (J2327)

Worked example — complete induction billing for a Crohn's patient

Premedication

Not required. Skyrizi is a non-chemotherapy IL-23 (p19-selective) monoclonal antibody. No routine pre-infusion methylprednisolone or antihistamine. Standard biologic safety: TB screening before initiation, monitor for hypersensitivity reactions during and after infusion.

NDC reference FDA NDC Directory verified May 2026

IBD biologic class comparison Reviewed May 2026

Where Skyrizi sits relative to the other approved IBD biologics. All FDA-approved for moderate-to-severe Crohn's disease and/or ulcerative colitis.

Administration codes CPT verified May 2026

Skyrizi is a non-chemotherapy biologic. Use therapeutic IV infusion codes (96365/96366), not chemo admin codes.

Modifiers CMS verified May 2026

JZ — required on virtually every Skyrizi IV claim

Effective July 1, 2023, CMS requires the JZ modifier on all single-dose container claims when no drug is discarded. Skyrizi IV induction uses a 600 mg / 10 mL single-dose vial for a fixed 600 mg dose — one vial in, full vial used, zero waste. JZ applies to virtually every J2327 claim.

JW — rare for Skyrizi

JW reports the discarded portion of a single-dose vial. Because Skyrizi IV uses a fixed 600 mg dose from a fixed 600 mg vial, partial-vial waste is uncommon. JW would only apply if the patient could not tolerate the full dose (e.g., infusion reaction stopped mid-administration). One of JZ or JW must be on every J2327 claim per CMS's July 2023 single-dose container policy.

Modifier 25 — same-day E/M

Use modifier 25 on the E/M code when a significant, separately identifiable evaluation and management service is performed on the same day as the infusion (e.g., GI clinic visit immediately before infusion for active flare assessment). Routine pre-infusion clinical assessment is bundled.

340B modifiers (JG, TB)

For 340B-acquired Skyrizi, follow your MAC's current 340B modifier policy. AbbVie's billing guide does not provide 340B-specific instructions.

ICD-10-CM — Crohn's disease and ulcerative colitis FY2026 verified May 2026

J2327 is appropriate only for moderate-to-severe IBD induction. Use the most specific code supported by encounter documentation.

Site of care & place of service Verified May 2026

UnitedHealthcare, Aetna, and most major BCBS plans run site-of-care UM for IBD biologic infusions. With only 3 induction infusions per patient, the site-of-care pressure is less acute than for chronic q8w infusion regimens (e.g., Remicade, Entyvio IV) but still applies.

Claim form field mapping AbbVie 2025

From AbbVie Skyrizi Complete provider billing reference materials and standard CMS-1500 conventions.

Payer policy snapshot + step therapy Reviewed May 2026

All major commercial payers require prior authorization for J2327 with documented IBD severity, prior biologic history, and step-therapy compliance.

Typical commercial step-therapy chain

Most commercial payers require documentation that the patient has failed, is intolerant of, or has a contraindication to:

• At least one anti-TNF (Humira / adalimumab biosimilars, or Remicade / infliximab biosimilars)
• And/or anti-integrin (Entyvio / vedolizumab)
• And/or another biologic (Stelara, Tremfya) depending on plan

Tofacitinib (Xeljanz) and upadacitinib (Rinvoq) are sometimes accepted as step-therapy alternatives, particularly in UC. Verify per-plan formulary tier.

Medicare reimbursement CMS Q2 2026 (live)

Quarterly ASP from CMS Part B Drug Pricing File. Refreshes automatically each quarter.

Coverage

No NCD specific to risankizumab. Coverage falls under MAC LCDs for biologics + the generic drug-coverage framework. All MACs cover J2327 for FDA-approved on-label IBD induction (moderate-to-severe Crohn's disease and ulcerative colitis) with appropriate ICD-10 documentation.

Code history

• J2327 — "Injection, risankizumab-rzaa, 1 mg" — permanent code; pre-permanent-code period used unclassified J3490 / J3590

Patient assistance — AbbVie Skyrizi Complete AbbVie verified May 2026

• Phone: 1-866-SKYRIZI (1-866-759-7494) — benefits investigation, prior authorization assistance, copay enrollment, appeal support
• Skyrizi Complete Savings Card: commercial copay support — eligible commercially-insured patients pay as little as $5/month (excludes Medicare, Medicaid, federal program patients)
• myAbbVie Assist (AbbVie Patient Assistance Foundation): free product for uninsured / underinsured patients meeting income requirements (administered as a 501(c)(3))
• Foundations: for Medicare patients, refer to Patient Advocate Foundation, HealthWell, IBD-specific funds — verify open IBD funds quarterly
• Web: skyrizi.com · skyrizicomplete.com

Common denials & how to fix them

Frequently asked questions

What is the HCPCS code for Skyrizi?

Skyrizi IV induction is billed under HCPCS J2327 — "Injection, risankizumab-rzaa, 1 mg." Each milligram equals one billable unit, so the standard 600 mg induction dose is billed as 600 units. J2327 applies only to the IV induction formulation used in Crohn's disease and ulcerative colitis. The subcutaneous formulations are pharmacy benefit and not billed under J2327.

What is the Skyrizi IV induction schedule?

For both moderate-to-severe Crohn's disease and ulcerative colitis: 600 mg IV over at least 60 minutes at weeks 0, 4, and 8 — three IV doses total. Each dose is one 600 mg / 10 mL single-dose vial. Maintenance starts at week 12 and uses subcutaneous Skyrizi 180 mg or 360 mg every 8 weeks (autoinjector, pharmacy benefit, NOT under J2327).

What administration CPT do I use for Skyrizi IV?

CPT 96365 (therapeutic IV infusion, initial up to 1 hour) for the first hour, plus 96366 (each additional hour) if infusion extends beyond 60 minutes. Skyrizi is a non-chemotherapy biologic — do NOT bill 96413 or 96415 (chemotherapy administration).

Is the IV vs SC distinction critical for billing?

Yes — this is the single most important Skyrizi billing decision. IV induction (600 mg, weeks 0/4/8) is medical benefit under J2327. SC maintenance (180 mg or 360 mg q8w autoinjector) is pharmacy benefit and dispenses through specialty pharmacy. Different prior auths, different specialty pharmacy networks, different cost-share. Submit the SC maintenance pharmacy PA in parallel with the medical PA for IV induction to avoid a gap at week 12.

Do I bill JZ or JW for Skyrizi?

Bill JZ on virtually every Skyrizi IV claim. The 600 mg induction dose uses exactly one 600 mg / 10 mL single-dose vial with zero waste. JW would only apply if a partial vial is discarded (e.g., infusion stopped mid-dose due to reaction) — rare. One of JZ or JW must be on every J2327 claim.

What is the Medicare reimbursement for J2327?

For Q2 2026, the Medicare Part B payment limit for J2327 is $14.599 per mg (ASP + 6%). The 600 mg induction dose reimburses at approximately $8,759.40 per infusion. Three induction doses total approximately $26,278.20. Sequestration (~2%) reduces actual paid to roughly ASP + 4.3%.

When was Skyrizi IV approved for ulcerative colitis?

AbbVie received FDA approval for Skyrizi in moderate-to-severe ulcerative colitis in 2024, expanding from the 2022 Crohn's disease approval. The UC regimen uses the same IV induction schedule (600 mg IV at weeks 0, 4, 8) followed by SC maintenance. This 2024 expansion materially grew the J2327 billing volume for many GI practices.

Where does Skyrizi sit in the IBD biologic class?

Skyrizi is one of two IL-23 (p19-selective) inhibitors approved for IBD induction-then-maintenance — Skyrizi (J2327) and Tremfya (J1628, FDA-approved for IBD in 2024). The broader IBD biologic class also includes anti-TNF (Humira J0135, Remicade J1745), anti-α4β7 integrin (Entyvio J3380), and anti-IL-12/23 (Stelara J3358). Most payers position IL-23 selective agents after a prior anti-TNF or anti-integrin trial.

Source documents

1. AbbVie — Skyrizi (risankizumab-rzaa) Prescribing Information
   FDA-approved label (current revision incorporates UC 2024 approval)
2. DailyMed — SKYRIZI (risankizumab-rzaa)
   Plaque psoriasis 2019; psoriatic arthritis 2022; Crohn's disease 2022; ulcerative colitis 2024
3. AbbVie Skyrizi Complete — HCP coding & coverage page
4. AbbVie press releases — 2022 Crohn's approval, 2024 UC approval
5. CMS — Medicare Part B Drug ASP Pricing File
   Q2 2026 quarterly file, effective April 1 – June 30, 2026
6. CMS HCPCS Level II — J2327 reference
7. UnitedHealthcare — Risankizumab Medical Drug Coverage Policy
8. Aetna CPB — Skyrizi (risankizumab-rzaa)
9. AGA — Clinical Practice Guidelines for IBD biologic therapy
10. ECCO — European Crohn's and Colitis Organisation guidelines
11. FDA National Drug Code Directory

About this page

We maintain this page as a living reference. Medicare ASP pricing is bound to our underlying CareCost data layer and refreshes automatically when CMS publishes new quarterly files. Coding and policy content is reviewed at least quarterly and updated whenever a source document changes.

Found an error? Email hello@carecostestimate.com.

Refresh cadence

Reviewer

Change log

• May 2, 2026 — Initial publication. ASP data: Q2 2026 ($14.599/mg). Manufacturer source: AbbVie 2025 Skyrizi Complete coding & coverage. FDA label: incorporates 2024 UC approval. Indications covered: Crohn's disease (2022), ulcerative colitis (2024) — the two indications that drive J2327 billing. SC-only indications (plaque psoriasis 2019, psoriatic arthritis 2022) noted as pharmacy-benefit only.

Methodology

Every claim on this page is sourced inline. Pricing reflects the current CMS Part B Drug ASP Pricing File. Payer policies are read directly from each payer's published medical/pharmacy policy documents. Indication list and dosing are verified against the current FDA label revision. We do not paraphrase from billing-software vendor blogs.