In short

CMS assigns Retacrit NDCs to 2 HCPCS codes: Q5105 (per 100 units), Q5106 (per 1000 units). Which one applies depends on the product; the table lists each NDC with its code.

Q5105 code detailsQ5106 code details

Reference

Q5105
Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), 100 unitsBilling unit: 100 units
Q5106
Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 unitsBilling unit: 1000 units
Labelers
Pfizer Inc; Vifor (International) Inc.

Medicare Part B payment limit

CMS ASP file
Payment limit per unit$0.817
Per100 units
Coinsurance20%

Effective October 1, 2026 through December 31, 2026. Payment allowance limits subject to the ASP methodology are based on 2Q26 ASP data. A payment limit is not a coverage decision; the Medicare contractor decides coverage. CMS ASP pricing files

Medicare Part B payment limit

CMS ASP file
Payment limit per unit$8.171
Per1000 units
Coinsurance20%

Effective October 1, 2026 through December 31, 2026. Payment allowance limits subject to the ASP methodology are based on 2Q26 ASP data. A payment limit is not a coverage decision; the Medicare contractor decides coverage. CMS ASP pricing files

Retacrit units and claim line

Enter the dose given to get the Q5105 units and the NDC line for the CMS-1500 and the 837P. This builds the Q5105 line; use the code page for Q5106.

Enter the dose given to build the claim line.

Retacrit 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.

Retacrit NDCs in the CMS ASP crosswalk
NDC (11-digit)HCPCSLabelerPackageBilling units per package
00069-1305-10Q5105Pfizer Inc10 × 1200
00069-1306-10Q5105Pfizer Inc10 × 1300
00069-1307-10Q5105Pfizer Inc10 × 1400
00069-1308-10Q5105Pfizer Inc10 × 11000
00069-1309-04Q5105Pfizer Inc4 × 11600
00069-1311-10Q5105Pfizer Inc10 × 12000
00069-1318-10Q5105Pfizer Inc10 × 21000
59353-0002-10Q5105Vifor (International) Inc.10 × 1200
59353-0003-10Q5105Vifor (International) Inc.10 × 1300
59353-0004-10Q5105Vifor (International) Inc.10 × 1400
59353-0120-10Q5105Vifor (International) Inc.10 × 12000
59353-0220-10Q5105Vifor (International) Inc.10 × 21000
00069-1305-10Q5106Pfizer Inc10 × 120
00069-1306-10Q5106Pfizer Inc10 × 130
00069-1307-10Q5106Pfizer Inc10 × 140
00069-1308-10Q5106Pfizer Inc10 × 1100
00069-1309-04Q5106Pfizer Inc4 × 1160
00069-1311-10Q5106Pfizer Inc10 × 1200
00069-1318-10Q5106Pfizer Inc10 × 2100
59353-0002-10Q5106Vifor (International) Inc.10 × 120
59353-0003-10Q5106Vifor (International) Inc.10 × 130
59353-0004-10Q5106Vifor (International) Inc.10 × 140
59353-0120-10Q5106Vifor (International) Inc.10 × 1200
59353-0220-10Q5106Vifor (International) Inc.10 × 2100

Retacrit: common questions

What is the HCPCS code for Retacrit?
CMS assigns Retacrit NDCs to 2 HCPCS codes: Q5105 (per 100 units), Q5106 (per 1000 units). Which one applies depends on the product; the table lists each NDC with its code.
How many Q5105 billing units are in a package of Retacrit?
CMS lists 200 to 2,000 billing units per package, depending on the NDC, where one unit is 100 units. Units to report are based on the dose given, not the package.
How many Q5106 billing units are in a package of Retacrit?
CMS lists 20 to 200 billing units per package, depending on the NDC, where one unit is 1000 units. Units to report are based on the dose given, not the package.
Is Q5105 a CPT code?
No. Q5105 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.

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