HCPCS drug code · CMS crosswalk
Otulfi HCPCS Code
In short
Otulfi is billed under HCPCS Q9999 — Injection, ustekinumab-aauz (otulfi), biosimilar, 1 mg. One billing unit is 1 mg. CMS's crosswalk lists 4 Otulfi NDCs under this code.
Reference
- Q9999
- Injection, ustekinumab-aauz (otulfi), biosimilar, 1 mgBilling unit: 1 mg
- Labelers
- FreseniUS Kabi USA, LLC
Medicare Part B payment limit
CMS ASP fileEffective October 1, 2026 through December 31, 2026. Payment allowance limits subject to the ASP methodology are based on 2Q26 ASP data. CMS note: "lesser of" methodology applied. A payment limit is not a coverage decision; the Medicare contractor decides coverage. CMS ASP pricing files
Otulfi units and claim line
Enter the dose given to get the Q9999 units and the NDC line for the CMS-1500 and the 837P.
Enter the dose given to build the claim line.
Otulfi NDCs and billing units
From CMS’s ASP NDC–HCPCS crosswalk, effective October 1, 2026 through December 31, 2026. Billing units per package are CMS’s figures for the code’s unit.
| NDC (11-digit) | HCPCS | Labeler | Package | Billing units per package |
|---|---|---|---|---|
| 65219-0822-05 | Q9999 | FreseniUS Kabi USA, LLC | 0.5 | 45 |
| 65219-0824-01 | Q9999 | FreseniUS Kabi USA, LLC | 0.5 | 45 |
| 65219-0826-26 | Q9999 | FreseniUS Kabi USA, LLC | 1 | 90 |
| 65219-0828-05 | Q9999 | FreseniUS Kabi USA, LLC | 26 | 130 |
Otulfi: common questions
- What is the HCPCS code for Otulfi?
- Otulfi is billed under HCPCS Q9999 — Injection, ustekinumab-aauz (otulfi), biosimilar, 1 mg. One billing unit is 1 mg. CMS's crosswalk lists 4 Otulfi NDCs under this code.
- How many Q9999 billing units are in a package of Otulfi?
- CMS lists 45 to 130 billing units per package, depending on the NDC, where one unit is 1 mg. Units to report are based on the dose given, not the package.
- Is Q9999 a CPT code?
- No. Q9999 is a HCPCS Level II code from CMS for the drug itself. Giving it, for example by injection or infusion, is usually reported with a separate CPT administration code.
Other codes for the same drug
- J3357Ustekinumab, for subcutaneous injection, 1 mg
- J3358Ustekinumab, for intravenous injection, 1 mg
- Q5098Injection, ustekinumab-srlf (imuldosa), biosimilar, 1 mg
- Q5099Injection, ustekinumab-stba (steqeyma), biosimilar, 1 mg
- Q5100Injection, ustekinumab-kfce (yesintek), biosimilar, 1 mg
- Q5137Injection, ustekinumab-auub (wezlana), biosimilar, subcutaneous, 1 mg
- Q5138Injection, ustekinumab-auub (wezlana), biosimilar, intravenous, 1 mg
- Q5164Injection, ustekinumab-hmny (starjemza), biosimilar, 1 mg
- Q9996Injection, ustekinumab-ttwe (pyzchiva), subcutaneous, 1 mg
- Q9997Injection, ustekinumab-ttwe (pyzchiva), intravenous, 1 mg