Q0167
Q0167 – Dronabinol, 2.5 mg, oral, fda approved prescription anti-emetic, for use · NDC Crosswalk & Billing Units
HCPCS Level II Q-code · Medicare Part B drug billing
Q-code
● 35 NDCs crosswalked per 2.5 MG $1.869/unit ASP+6%
📋 Q0167 summary
Q0167 is a HCPCS Level II Q-code used to bill Dronabinol, 2.5 mg, oral, fda approved prescription anti-emetic, for use as a complete the..., billed per 2.5 MG. The number of billing units to report depends on the dose administered and the NDC/package billed — use the calculator below.
Brand names associated with Q0167: Marinol
Code Q0167
Billing unit 2.5 MG Payment limit $1.869/unit NDC-Crosswalk 35
Quarter Q3 2026
RxCUI Atlas Trace the drug concept →
⚠ An NDC↔HCPCS crosswalk and a published payment limit do not guarantee payer coverage or payment. Always verify the current payer policy and claim format before billing.
🗂️ Key billing facts
HCPCS codeQ0167
DescriptorDronabinol, 2.5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
Billing unit2.5 MG
Payment limit / unit$1.869
Est. ASP / unit$1.763 est.
Mapped NDCs35
Data periodQ3 2026
Last updated2026-09-20
💊 About Dronabinol DRUG GUIDE
Dronabinol is used in adults for two conditions.
Both are supported for the oral capsule and oral solution products.Anorexia (loss of appetite) with weight loss in people with AIDS.Nausea and vomiting from cancer chemotherapy in people who haven't responded well enough to conventional anti-nausea medicines.This applies to Marinol and dronabinol capsules, and to Syndros and dronabinol oral solution.
Clinical overview from our editorial drug guide for Dronabinol. For billing reference, see the sections above.
🧾 Billing & reimbursement HCPCS · CMS · EFF. Q3 2026
📅 Payment limits effective Q3 2026 — from the CMS Medicare Part B Payment Limit File (revised quarterly).
Medicare payment limit / unit
$1.869
Est. ASP / unit
$1.763 est.
Est. after 2% sequester
$1.832
HCPCS dosage
2.5 MG
The CMS payment limit is the Medicare Part B drug allowance (ASP + 6%, statutory). After the 2% federal sequester the effective payment is ≈ ASP + 4.3%; estimated ASP = payment limit ÷ 1.06. Source: CMS Medicare Part B Payment Limit File (quarterly), Q3 2026.
Full HCPCS code details (official CMS record)
Long descriptionDronabinol, 2.5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen
CoverageD — Special coverage instructions apply
Pricing indicator51 — Drug — priced under the ASP methodology
Type of service1 — Medical care
BETOS-2O1D
ASC payment group—
Action codeN — No maintenance this year
Effective date1998-04-01
Date added1998-04-01
Source: CMS HCPCS Level II code file (imported via admin).
🧮 Dosing & billing-units calculator HCPCS UNITS
One billing unit of Q0167 = 2.5 mg. Enter a regimen to convert dose → billing units and project a full course.
Billing units = dose ÷ HCPCS unit size. Most payers require whole units — round per the payer's policy. “Est. Medicare pay” uses the current payment limit. For single-dose vials, drug discarded after administration may be separately billable with modifier JW (JZ when none is discarded) where allowed. Always verify payer-specific rounding before billing.
🔁 NDCs that bill under Q0167 LEAST EXPENSIVE FIRST
35 NDCs map to Q0167. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($1.869/unit) × that package's bill units.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | Est. pay / pkg | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|---|
| 00904-7144-61 | Dronabinol 2.5 mg/1 CAPSULE | Major | 100 BLISTER PACK in 1 CARTON (0904-7144-61... | 2.5 mg/1 | 100 | $186.90 | $1.516 | ● Active | CMS + PDAC |
| 67877-0753-60 | Dronabinol 2.5 mg/1 CAPSULE | Ascend | 60 CAPSULE in 1 BOTTLE (67877-753-60) | 2.5 mg/1 | 60 | $112.14 | $1.516 | ● Active | CMS + PDAC |
| 31722-0960-60 | DRONABINOL 2.5 mg/1 CAPSULE | Camber | 60 CAPSULE in 1 BOTTLE (31722-960-60) | 2.5 mg/1 | 1 | $1.87 | $1.516 | ● Active | PDAC |
| 00904-7145-04 | Dronabinol 5 mg/1 CAPSULE | Major | 30 BLISTER PACK in 1 CARTON (0904-7145-04)... | 5 mg/1 | 60 | $112.14 | $3.354 | ● Active | CMS + PDAC |
| 67877-0754-60 | Dronabinol 5 mg/1 CAPSULE | Ascend | 60 CAPSULE in 1 BOTTLE (67877-754-60) | 5 mg/1 | 120 | $224.28 | $3.354 | ● Active | CMS + PDAC |
| 31722-0961-60 | DRONABINOL 5 mg/1 CAPSULE | Camber | 60 CAPSULE in 1 BOTTLE (31722-961-60) | 5 mg/1 | 2 | $3.74 | $3.354 | ● Active | PDAC |
| 67877-0755-60 | Dronabinol 10 mg/1 CAPSULE | Ascend | 60 CAPSULE in 1 BOTTLE (67877-755-60) | 10 mg/1 | 240 | $448.56 | $4.032 | ● Active | CMS + PDAC |
| 31722-0962-60 | DRONABINOL 10 mg/1 CAPSULE | Camber | 60 CAPSULE in 1 BOTTLE (31722-962-60) | 10 mg/1 | 4 | $7.48 | $4.032 | ● Active | PDAC |
| 53097-0571-60 | MARINOL Dronabinol 2.5 mg/1 CAPSULE | ThePharmaNetwork, | 60 CAPSULE in 1 BOTTLE (53097-571-60) | 2.5 mg/1 | 60 | $112.14 | — | ● Active | CMS + PDAC |
| 60687-0375-01 | Dronabinol | American | — | — | 100 | $186.90 | — | — | CMS ASP |
| 60687-0375-21 | Dronabinol | American | — | — | 30 | $56.07 | — | — | CMS ASP |
| 60687-0386-21 | Dronabinol | American | — | — | 60 | $112.14 | — | — | CMS ASP |
| 60687-0386-94 | Dronabinol | American | — | — | 40 | $74.76 | — | — | CMS ASP |
| 42858-0869-06 | DRONABINOL (SOFTGEL) 10 MG | Unknown | — | — | 4 | $7.48 | — | — | PDAC |
| 42858-0868-06 | DRONABINOL (USP,SOFT GELATIN) 5 MG | Unknown | — | — | 2 | $3.74 | — | — | PDAC |
| 42858-0867-06 | DRONABINOL (USP,SOFT GELATIN) 2.5 MG | Unknown | — | — | 1 | $1.87 | — | — | PDAC |
| 53097-0570-60 | Marinol Dronabinol 10 mg/1 CAPSULE | ThePharmaNetwork, | 1 BOTTLE in 1 CARTON (53097-570-60) / 60... | 10 mg/1 | 4 | $7.48 | — | ● Active | PDAC |
| 53097-0569-60 | Marinol Dronabinol 5 mg/1 CAPSULE | ThePharmaNetwork, | 1 BOTTLE in 1 CARTON (53097-569-60) / 60... | 5 mg/1 | 2 | $3.74 | — | ● Active | PDAC |
| 53097-0568-60 | Marinol Dronabinol 2.5 mg/1 CAPSULE | ThePharmaNetwork, | 1 BOTTLE in 1 CARTON (53097-568-60) / 60... | 2.5 mg/1 | 1 | $1.87 | — | ● Active | PDAC |
| 42291-0451-60 | DRONABINOL (SOFT GELATIN) 10 MG | Unknown | — | — | 4 | $7.48 | — | — | PDAC |
| 42291-0450-60 | DRONABINOL (SOFT GELATIN) 5 MG | Unknown | — | — | 2 | $3.74 | — | — | PDAC |
| 42291-0449-60 | DRONABINOL (SOFT GELATIN) 2.5 MG | Unknown | — | — | 1 | $1.87 | — | — | PDAC |
| 00527-1452-06 | DRONABINOL (SOFT GEL) 10 MG | Unknown | — | — | 4 | $7.48 | — | — | PDAC |
| 00527-1451-06 | DRONABINOL (SOFT GEL) 5 MG | Unknown | — | — | 2 | $3.74 | — | — | PDAC |
| 00527-1450-06 | DRONABINOL (SOFT GEL) 2.5 MG | Unknown | — | — | 1 | $1.87 | — | — | PDAC |
| 00904-6746-04 | DRONABINOL (USP,SOFT GELATIN) 5 MG | Unknown | — | — | 2 | $3.74 | — | — | PDAC |
| 00904-6745-61 | DRONABINOL (USP,SOFT GELATIN) 2.5 MG | Unknown | — | — | 1 | $1.87 | — | — | PDAC |
| 67877-0568-60 | DRONABINOL (SOFT GELATIN) 2.5 MG | Unknown | — | — | 1 | $1.87 | — | — | PDAC |
| 67877-0569-60 | DRONABINOL (SOFT GELATIN) 5 MG | Unknown | — | — | 2 | $3.74 | — | — | PDAC |
| 67877-0570-60 | DRONABINOL (SOFT GELATIN) 10 MG | Unknown | — | — | 4 | $7.48 | — | — | PDAC |
| 00051-0023-21 | MARINOL (SOFTGEL) 10 MG | Unknown | — | — | 4 | $7.48 | — | — | PDAC |
| 00051-0022-21 | MARINOL (SOFT GELATIN) 5 MG | Unknown | — | — | 2 | $3.74 | — | — | PDAC |
| 54868-3084-01 | MARINOL 2.5 MG | Unknown | — | — | 1 | $1.87 | — | — | PDAC |
| 00051-0021-21 | MARINOL 2.5 MG | Unknown | — | — | 1 | $1.87 | — | — | PDAC |
| 54868-3084-00 | MARINOL (SOFTGEL) 2.5 MG | Unknown | — | — | 1 | $1.87 | — | — | PDAC |
NDC→HCPCS mappings come from the CMS ASP NDC-HCPCS crosswalk; additional DME MAC / DMEPOS mappings come from PDAC and are labeled separately. NADAC from CMS (weekly). “Status” reflects the product's marketing / obsolete flag in the NDC directory. Presence or absence here does not determine Medicare coverage. Linked NDCs open the full product page.
📈 Medicare Part B claims detail CMS PSPS · 2024
Calendar-year 2024 Medicare Part B fee-for-service activity for this HCPCS code, summed across all carriers, localities and specialties (CMS Physician/Supplier Procedure Summary). A “service” is one billed line/unit — not one claim — so counts run higher than claim counts.
Allowed charges
$732.59
Medicare paid
$574.36
Submitted services
960
Denial rate
51.3%
Allowed / service
$1.57
Submitted charges
$4.8K
Source: CMS Physician/Supplier Procedure Summary (PSPS), CY2024 — Medicare Part B carrier + DME fee-for-service claims (excludes Medicare Advantage). Figures are for the whole HCPCS code, which may cover uses beyond this drug. ⚠ CMS hides any figure covering fewer than 11 patients (a privacy rule), so totals — especially denials and low-volume codes — run a little low.
🗺️ Where Q0167 is utilized
⏳
The geographic utilization map is building for this code — it aggregates millions of CMS Part B claim lines, then caches the result. Refresh in a moment; if it doesn’t appear, this code may have no reportable Part B utilization.
📊 What bills under Q0167
J-codes are billing codes often used for drugs billed under the medical benefit. This connects the billing code to the NDC package records it covers, by ingredient and labeler.
NDC products by ingredient
NDC products by labeler
🗃️ Data sources & freshness
Every figure on this page is computed from public datasets. Here's what each section draws on and how current it is.
HCPCS code & descriptor
CMS HCPCS Level II code file
Loaded
Payment limit & billing unit
CMS Medicare Part B ASP Pricing File (quarterly)
Q3 2026 · as of 2026-09-20
NDC ↔ HCPCS crosswalk
CMS ASP NDC-HCPCS crosswalk + DMEPDAC (PDAC)
35 NDCs mapped
NADAC acquisition cost
CMS National Average Drug Acquisition Cost (weekly)
Available for mapped NDCs
Utilization & spend
CMS Part B Spending by Drug · PSPS · Physician & Other Practitioners
No reportable utilization
Figures are estimates for reference and may lag the source files. Always verify against the current CMS files and your payer's policy before submitting claims.
⚠️ Practical billing caveats
- A crosswalk is not coverage. An NDC mapping or a published payment limit does not guarantee a payer will cover or pay this code. Check the specific plan's policy.
- Units ≠ milligrams. Bill the number of HCPCS units (dose ÷ the code's unit size), not the milligram dose. Use the calculator above.
- Discarded drug. For single-dose vials, drug discarded after administration may be separately billable with modifier JW (and JZ when nothing is discarded) where the payer allows.
- Rounding & partial units. Many payers require whole units; round per the payer's policy, not automatically up.
- The code can cover more than this drug. Some HCPCS codes span multiple products or strengths — confirm the exact code for the product administered.
- Figures lag. ASP limits change quarterly and utilization data are released with a delay. Verify against the current CMS files before billing.
❓ Q0167 billing FAQ
What is HCPCS code Q0167?
Q0167 is a HCPCS Level II Q-code used to bill Dronabinol, 2.5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for Q0167?
One unit of Q0167 represents 2.5 MG. Report the number of units equal to the dose administered divided by 2.5 MG.
How many units of Q0167 should I bill?
Divide the dose administered by the code's unit size (2.5 MG) to get the number of billing units, then round per your payer's policy. The calculator on this page converts a dose into billing units and projects a full course.
How much does Medicare pay for Q0167?
The Medicare Part B payment limit is $1.869 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $1.832 per unit. Payment limits are revised quarterly.
Which NDCs bill under Q0167?
35 NDCs currently map to Q0167 in the CMS ASP NDC-HCPCS crosswalk. See the NDC crosswalk table above for each product, package, billing units and estimated reimbursement.
Does a crosswalk mean Q0167 is covered?
No. An NDC-to-HCPCS crosswalk and a published payment limit do not guarantee coverage or payment. Coverage depends on the payer, the diagnosis and the site of care — always verify the current policy before billing.
For professional billing reference only — verify against the current CMS files before submitting claims.