Date Posted: July 16, 2026

This billing and coding article has been revised and published for notice under contract numbers: 02102 (AK), 02202 (ID), 02302 (OR), 02402 (WA), 03102 (AZ), 03202 (MT), 03302 (ND), 03402 (SD), 03502 (UT), and 03602 (WY).

Effective Date: August 29, 2026

Summary of Changes:

Under Excluded CPT/HCPCS Codes, added Q5164 Injection, ustekinumab-hmny (starjemza), biosimilar, 1 mg* and J3490, J3590, C9399 bimekizumab-bkzx (Bimzelx®)

Visit the Self-Administered Drugs (SADs) webpage to view the Self-Administered Drug Exclusion List.

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