HCPCS Code Details - Q5123

HCPCS Level II Code
Miscellaneous Services (Temporary Codes)
HCPCS Code Q5123
Description

Long description:
Injection, rituximab-arrx, biosimilar, (riabni), 10 mg

Short description:
Inj. riabni, 10 mg

HCPCS Modifier1
HCPCS Pricing indicator 51 - Drugs
Multiple pricing indicator A - Not applicable as HCPCS priced under one methodology
Coverage code C - Carrier judgment
ASC payment group code Effective Jul 01, 2021 - This procedure is approved to be performed in an ambulatory surgical center.
BETOS2 code O1D - Chemotherapy
HCPCS Action code N - No maintenance for this code
Type of service 1 - Medical care
Effective date Effective Jul 01, 2021
Date added Added Jul 01, 2021
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 - Q5123

Effective Code Dosage Payment
Limit
Vaccine AWP % Vaccine Limit Infusion AWP % DME infusion limit Blood AWP % Blood limit Clotting factor Note
Jul 1, 2024 - Sep 30, 2024 10 MG 40.372 - - - - - -
April 1, 2024 - June 30, 2024 10 MG 41.418 - - - - - -
January 1, 2024 - March 31, 2024 10 MG 41.419 - - - - - -
October 1, 2023 - December 31, 2023 10 MG 43.475 20% - - - - -
Jul 1, 2023 - Sep 30, 2023 10 MG 44.579 20% - - - - -

See also

  • HCPCS Q5122 · Injection, pegfilgrastim-apgf (nyvepria), biosimilar, 0.5 mg

  • HCPCS Q5124 · Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg


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”