HCPCS drug code · CMS crosswalk
Sublocade HCPCS Code
In short
CMS assigns Sublocade NDCs to 2 HCPCS codes: Q9991 (per less than or equal to 100 mg), Q9992 (per greater than 100 mg). Which one applies depends on the product; the table lists each NDC with its code.
Reference
- Q9991
- Injection, buprenorphine extended-release (sublocade), less than or equal to 100 mgBilling unit: less than or equal to 100 mg
- Q9992
- Injection, buprenorphine extended-release (sublocade), greater than 100 mgBilling unit: greater than 100 mg
- Labelers
- Indivior Inc.
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. A payment limit is not a coverage decision; the Medicare contractor decides coverage. CMS ASP pricing files
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. A payment limit is not a coverage decision; the Medicare contractor decides coverage. CMS ASP pricing files
Sublocade units and claim line
Enter the dose given to get the Q9991 units and the NDC line for the CMS-1500 and the 837P. This builds the Q9991 line; use the code page for Q9992.
Enter the units to build the claim line.
Sublocade 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 |
|---|---|---|---|---|
| 12496-0100-01 | Q9991 | Indivior Inc. | 0.5 | 1 |
| 12496-0300-01 | Q9992 | Indivior Inc. | 1.5 | 1 |
Sublocade: common questions
- What is the HCPCS code for Sublocade?
- CMS assigns Sublocade NDCs to 2 HCPCS codes: Q9991 (per less than or equal to 100 mg), Q9992 (per greater than 100 mg). Which one applies depends on the product; the table lists each NDC with its code.
- How many Q9991 billing units are in a package of Sublocade?
- CMS lists 1 billing units per package, depending on the NDC, where one unit is less than or equal to 100 mg. Units to report are based on the dose given, not the package.
- How many Q9992 billing units are in a package of Sublocade?
- CMS lists 1 billing units per package, depending on the NDC, where one unit is greater than 100 mg. Units to report are based on the dose given, not the package.
- Is Q9991 a CPT code?
- No. Q9991 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
- J0570Buprenorphine implant, 74.2 mg
- J0571Buprenorphine, oral, 1 mg
- J0572Buprenorphine/naloxone, oral, less than or equal to 3 mg buprenorphine
- J0573Buprenorphine/naloxone, oral, greater than 3 mg, but less than or equal to 6 mg buprenorphine
- J0574Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine
- J0575Buprenorphine/naloxone, oral, greater than 10 mg buprenorphine
- J0577Injection, buprenorphine extended-release (brixadi), less than or equal to 7 days of therapy
- J0578Injection, buprenorphine extended release (brixadi), greater than 7 days and up to 28 days of therapy
- J0592Injection, buprenorphine hydrochloride, 0.1 mg