HCPCS Code Details - Q2055

HCPCS Level II Code
Miscellaneous Services (Temporary Codes)
HCPCS Code Q2055
Description

Long description:
Idecabtagene vicleucel, up to 460 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose

Short description:
Idecabtagene vicleucel car

HCPCS Modifier1
HCPCS Pricing indicator 51 - Drugs
Multiple pricing indicator A - Not applicable as HCPCS priced under one methodology
Coverage code C - Carrier judgment
BETOS2 code O1D - Chemotherapy
HCPCS Action code N - No maintenance for this code
Type of service 1 - Medical care
Effective date Effective Jan 01, 2022
Date added Added Jan 01, 2022
HCPCS Coding Procedures

HCPCS Modifiers

In HCPCS Level II, modifiers are composed of two alpha or alphanumeric characters.

Example: E0260-NU - Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress
NU” identifies the hospital bed as new equipment

ASP Drug pricing - Q2055

Effective Code Dosage Payment
Limit
Vaccine AWP % Vaccine Limit Infusion AWP % DME infusion limit Blood AWP % Blood limit Clotting factor Note
April 1, 2024 - June 30, 2024 UP TO 460 MILLION AUTOLOGOUS ANTI-BCMA CAR-POSITIVE VIABLE T CEL 484690.3 - - - - - -
January 1, 2024 - March 31, 2024 UP TO 460 MILLION AUTOLOGOUS ANTI-BCMA CAR-POSITIVE VIABLE T CEL 484690.3 - - - - - -
October 1, 2023 - December 31, 2023 UP TO 460 MILLION AUTOLOGOUS ANTI-BCMA CAR-POSITIVE VIABLE T CEL 483453.66 20% - - - - -

See also

  • HCPCS Q2054 · Lisocabtagene maraleucel, up to 110 million autologous anti-cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose

  • HCPCS C9081 · Idecabtagene vicleucel, up to 460 million autologous anti-bcma car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose

  • HCPCS Q2056 · Ciltacabtagene autoleucel, up to 100 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose


1 Two-digit numeric codes are Level I code modifiers copyrighted© by the American Medical Association's Current Procedural Terminology (CPT).

2 BETOS stands for “Berenson-Eggers Type Of Service”