Article Detail - JE Part B
Self-Administered Drug Exclusion List (A53032) - R41 - Effective January 1, 2025
Date Posted: January 2, 2025
This billing and coding article has been revised and published for notice under contract numbers: 01112 (NCA), 01182 (SCA), 01212 (AS, GU, HI, NMI), and 01312 (NV).
Effective Date: January 1, 2025
Summary of Changes:
EXCLUDED CPT/HCPCS CODES:
Added: CPT/HCPCS codes Q9998 Injection, ustekinumab-aekn (selarsdi), 1 mg*; Q9996 ustekinumab-ttwe (pyzchiva); J0139 Injection, adalimumab, 1 mg; Q5142 Injection, adalimumab-ryvk biosimilar, 1 mg; Q5143 Injection, adalimumab-adbm, biosimilar, 1 mg; Q5140 Injection, adalimumab-fkjp, biosimilar, 1 mg; Q5141 Injection, adalimumab-aaty, biosimilar, 1 mg; Q5144 Injection, adalimumab-aacf (idacio), biosimilar, 1 mg; and Q5145 Injection, adalimumab-afzb (abrilada), biosimilar, 1 mg
Deleted: CPT/HCPCS codes Q5132 Abrilada injection, adalimumab-afzb (abrilada); Q5131 Adalimumab-aacf (Idacio®); and J0135 Injection, adalumumab, 20 mg
Visit the Self-Administered Drugs (SADs) webpage to view the Self-Administered Drug Exclusion List.
To view the complete listing of billing and coding articles and/or access the Active, Future, or Retired articles available in the CMS MCD, visit the Billing and Coding Articles webpage.
