HCPCS Code Details - Q5126

HCPCS Level II Code
Miscellaneous Services (Temporary Codes)
HCPCS Code Q5126
Description

Long description:
Injection, bevacizumab-maly, biosimilar, (alymsys), 10 mg

Short description:
Inj alymsys 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 Jan 01, 2023 - 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 Jan 01, 2023
Date added Added Jan 01, 2023
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 - Q5126

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 57.724 - - - - - -
April 1, 2024 - June 30, 2024 10 MG 58.811 - - - - - -
January 1, 2024 - March 31, 2024 10 MG 60.584 - - - - - -
October 1, 2023 - December 31, 2023 10 MG 63.916 20% - - - - -
Jul 1, 2023 - Sep 30, 2023 10 MG 72.518 20% - - - - -

See also

  • HCPCS Q5125 · Injection, filgrastim-ayow, biosimilar, (releuko), 1 microgram

  • HCPCS C9142 · Injection, bevacizumab-maly, biosimilar, (alymsys), 10 mg

  • HCPCS Q5127 · Injection, pegfilgrastim-fpgk (stimufend), biosimilar, 0.5 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”