S0126 – Injection, follitropin alfa, 75 iu
HCPCS Level II code · S codes: Temporary National Codes (Non-Medicare)
HCPCS codeS0126
- Long description
- Injection, follitropin alfa, 75 iu
- Short description
- Inj follitropin alfa 75 iu
- Pricing indicator
00Not separately priced by Part B (bundled, not covered or Part A only)- Medicare coverage
INot payable by Medicare- BETOS category
Z2Undefined codes- Added
- April 1, 2002
- Last change
- April 1, 2002 – No change
Frequently asked questions
What is HCPCS code S0126?
S0126 is a HCPCS Level II code for injection, follitropin alfa, 75 iu.
Does Medicare cover S0126?
The HCPCS file lists coverage code I: Not payable by Medicare. Coverage and payment also depend on local coverage determinations and the patient’s plan.
Nearby S codes
- S0093 – Injection, morphine sulfate, 500 mg (loading dose for infusion pump)
- S0104 – Zidovudine, oral, 100 mg
- S0106 – Bupropion hcl sustained release tablet, 150 mg, per bottle of 60 tablets
- S0108 – Mercaptopurine, oral, 50 mg
- S0109 – Methadone, oral, 5 mg
- S0117 – Tretinoin, topical, 5 grams
- S0119 – Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code)
- S0122 – Injection, menotropins, 75 iu
- S0128 – Injection, follitropin beta, 75 iu
- S0132 – Injection, ganirelix acetate, 250 mcg
- S0136 – Clozapine, 25 mg
- S0137 – Didanosine (ddi), 25 mg
- S0138 – Finasteride, 5 mg
- S0139 – Minoxidil, 10 mg
- S0140 – Saquinavir, 200 mg
- S0142 – Colistimethate sodium, inhalation solution administered through dme, concentrated form, per mg
Source: CMS HCPCS Level II quarterly file, October 2026. Reference only – check payer policy before billing.