Q9999 — Injection, ustekinumab-aauz (otulfi), biosimilar, 1 mg
Q9999 is a HCPCS Level II code for injection, ustekinumab-aauz (otulfi), 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 statusE
Excluded from the physician fee schedule by regulation. Payment, where it exists, comes from another fee schedule (drugs via ASP, supplies via DMEPOS, and so on).
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 Q9999 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
- 520 units MAI 3 — Date of Service Edit: Clinical · Prescribing Information
- outpatient
- 520 units MAI 3 — Date of Service Edit: Clinical · Prescribing Information
- DME supplier
- 520 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 Q9999
- Long descriptor
- Injection, ustekinumab-aauz (otulfi), biosimilar, 1 mg
- Short descriptor
- Inj ustekinumab-aauz 1 mg
- Added
- April 1, 2025
- BETOS
- O1E
- Pricing indicator
- 51 — Other
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Drugs.
Codes adjacent to Q9999
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If Q9999 is not quite right, the correct code is very often within a few positions of it.
- Q9991Injection, buprenorphine extended-release (sublocade), less than or equal to 100 mg
- Q9992Injection, buprenorphine extended-release (sublocade), greater than 100 mg
- Q9993Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mgterminated
- Q9994In-line cartridge containing digestive enzyme(s) for enteral feeding, eachterminated
- Q9995Injection, emicizumab-kxwh, 0.5 mgterminated
- Q9996Injection, ustekinumab-ttwe (pyzchiva), subcutaneous, 1 mg
- Q9997Injection, ustekinumab-ttwe (pyzchiva), intravenous, 1 mg
- Q9998Injection, ustekinumab-aekn (selarsdi), biosimilar, 1 mg
- R0070Transportation of portable x-ray equipment and personnel to home or nursing home, per trip to facility or location, one patient seen
- R0075Transportation of portable x-ray equipment and personnel to home or nursing home, per trip to facility or location, more than one patient seen
- R0076Transportation of portable ekg to facility or location, per patient
- S0012Butorphanol tartrate, nasal spray, 25 mg
- S0013Esketamine, nasal spray, 1 mgterminated
- S0014Tacrine hydrochloride, 10 mg
- S0017Injection, aminocaproic acid, 5 gramsterminated
- S0020Injection, bupivicaine hydrochloride, 30 mlterminated
Questions about Q9999
What is HCPCS code Q9999?
Q9999 is a HCPCS Level II code for injection, ustekinumab-aauz (otulfi), biosimilar, 1 mg. It sits in the Temporary Codes section.
Does Medicare cover Q9999?
The CMS HCPCS file marks Q9999 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 Q9999 paid under the physician fee schedule?
Q9999 carries PFS status code E. Excluded from the physician fee schedule by regulation. Payment, where it exists, comes from another fee schedule (drugs via ASP, supplies via DMEPOS, and so on).