In short

Q5100 is the HCPCS Level II code for injection, ustekinumab-kfce (yesintek), biosimilar, 1 mg. CMS assigns NDCs for Yesintek to it. One billing unit is 1 mg. The Medicare Part B payment limit is $3.08 per unit (October 1, 2026 through December 31, 2026).

Code

CMS HCPCS file
HCPCS codeQ5100
Billing unit1 mg
Descriptor
Injection, ustekinumab-kfce (yesintek), biosimilar, 1 mg
Short descriptor
Inj ustekinumab-kfce, 1 mg
Code set
HCPCS Level II, maintained by CMS
Effective
Jul 1, 2025

The billing unit is read from the descriptor. Confirm it against the CMS file before billing.

Medicare Part B payment limit

CMS ASP file
Payment limit per unit$3.08
Per1 mg
Coinsurance20%

Effective 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; 8% of reference add-on applied. A payment limit is not a coverage decision; the Medicare contractor decides coverage. CMS ASP pricing files

Units and claim line

Units = dose given ÷ 1 mg. For example, 100 mg is 100 units. Enter the dose to get the units and the NDC line for the CMS-1500 and the 837P.

Enter the dose given to build the claim line.

NDCs billed under Q5100

CMS’s ASP NDC–HCPCS crosswalk (effective October 1, 2026 through December 31, 2026) assigns 4 NDCs to Q5100 for Yesintek. Billing units per package are CMS’s figures for this code’s unit.

NDCs assigned to Q5100 in the CMS ASP crosswalk
DrugNDC (11-digit)LabelerPackageBilling units per package
Yesintek83257-0023-41Biocon Biologics Inc0.545
Yesintek83257-0024-11Biocon Biologics Inc0.545
Yesintek83257-0025-41Biocon Biologics Inc190
Yesintek83257-0026-11Biocon Biologics Inc26130

Q5100: common questions

Is Q5100 a CPT code?
No. Q5100 is a HCPCS Level II code, maintained by CMS, that identifies the drug supplied. CPT codes are five-digit numbers from the AMA that describe services. Giving the drug, for example an injection or infusion, is usually reported with a separate CPT administration code. CPT codes for drug administration.
What NDCs are billed under Q5100?
CMS's ASP crosswalk for October 1, 2026 through December 31, 2026 lists 4 NDCs under Q5100, for Yesintek. The table on this page shows each one with its billing units per package.
What is the Medicare payment limit for Q5100?
$3.08 per 1 mg, effective October 1, 2026 through December 31, 2026, from CMS's Part B drug payment limit file. Multiply by the units billed for the allowed amount before deductible and coinsurance. It is not a coverage decision.
What is one billing unit of Q5100?
One unit of Q5100 is 1 mg, as stated in the code's descriptor. Units to report = dose given ÷ 1 mg. J-code billing units.

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