MCMCB Pro
Q5144

Q5144Injection, adalimumab-aacf (idacio), biosimilar, 1 mg

HCPCSActiveBETOS O1E

Q5144 is a HCPCS Level II code for injection, adalimumab-aacf (idacio), biosimilar, 1 mg. It belongs to the Temporary Codes section. Whether Medicare pays it depends on the coverage rule below.

Medicare coverage: Carrier judgment

Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.

From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.

Physician fee schedule statusN

Non-covered service. Medicare does not cover it.

Global period: XXX

Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.

Medically Unlikely Edits — units per day

The most units of Q5144 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.

practitioner
160 units
MAI 3 — Date of Service Edit: Clinical · Prescribing Information
outpatient
160 units
MAI 3 — Date of Service Edit: Clinical · Prescribing Information
DME supplier
160 units
MAI 3 — Date of Service Edit: Clinical · Prescribing Information

The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.

The CMS record for Q5144

Long descriptor
Injection, adalimumab-aacf (idacio), biosimilar, 1 mg

The official wording. This is what the code means.

Short descriptor
Inj, idacio, 1 mg

CMS's 28-character form, which is what shows up on a remittance advice.

Added
January 1, 2025

When CMS introduced the code.

BETOS
O1E

Berenson-Eggers Type of Service — CMS's own analytic grouping.

Pricing indicator
51 — Other

Drugs.

Codes adjacent to Q5144

HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If Q5144 is not quite right, the correct code is very often within a few positions of it.

  • Q5136Injection, denosumab-bbdz (jubbonti/wyost), biosimilar, 1 mg
  • Q5137Injection, ustekinumab-auub (wezlana), biosimilar, subcutaneous, 1 mg
  • Q5138Injection, ustekinumab-auub (wezlana), biosimilar, intravenous, 1 mg
  • Q5139Injection, eculizumab-aeeb (bkemv), biosimilar, 10 mgterminated
  • Q5140Injection, adalimumab-fkjp, biosimilar, 1 mg
  • Q5141Injection, adalimumab-aaty, biosimilar, 1 mg
  • Q5142Injection, adalimumab-ryvk biosimilar, 1 mg
  • Q5143Injection, adalimumab-adbm, biosimilar, 1 mg
  • Q5145Injection, adalimumab-afzb (abrilada), biosimilar, 1 mg
  • Q5146Injection, trastuzumab-strf (hercessi), biosimilar, 10 mg
  • Q5147Injection, aflibercept-ayyh (pavblu), biosimilar, 1 mg
  • Q5148Injection, filgrastim-txid (nypozi), biosimilar, 1 microgram
  • Q5149Injection, aflibercept-abzv (enzeevu), biosimilar, 1 mg
  • Q5150Injection, aflibercept-mrbb (ahzantive), biosimilar, 1 mg
  • Q5151Injection, eculizumab-aagh (epysqli), biosimilar, 2 mg
  • Q5152Injection, eculizumab-aeeb (bkemv), biosimilar, 2 mg

Questions about Q5144

What is HCPCS code Q5144?

Q5144 is a HCPCS Level II code for injection, adalimumab-aacf (idacio), biosimilar, 1 mg. It sits in the Temporary Codes section.

Does Medicare cover Q5144?

The CMS HCPCS file marks Q5144 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.

How is Q5144 paid under the physician fee schedule?

Q5144 carries PFS status code N. Non-covered service. Medicare does not cover it.

HCPCS Level II2026Q3-Jul· effective July 1, 2026