Q9999 NDC Crosswalk, Billing Units, ASP Payment & Medicare Reimbursement

📋 Q9999 summary

Q9999 is a HCPCS Level II Q-code used to bill ustekinumab-aauz 1 mg, billed per 1 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 Q9999: Otulfi, Ustekinumab-Aauz

Code Q9999 Billing unit 1 MG Payment limit $13.154/unit NDC-Crosswalk 6 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 codeQ9999

DescriptorInj ustekinumab-aauz 1 mg

Billing unit1 MG

Payment limit / unit$13.154

Est. ASP / unit$12.409 est.

Mapped NDCs6

Data periodQ3 2026

Last updated2026-09-20

💊 About Ustekinumab Injection DRUG GUIDE

Ustekinumab Injection treats several long-term inflammatory conditions.

These include moderate to severe plaque psoriasis and active psoriatic arthritis in adults and children 6 years and older.It also treats moderately to severely active Crohn's disease and moderately to severely active ulcerative colitis in adults and children 2 years and older.

For plaque psoriasis, it is for people who are candidates for light therapy (phototherapy) or systemic therapy (medicine that works throughout the body).

Read the full Ustekinumab Injection drug guide →

Clinical overview from our editorial drug guide for Ustekinumab Injection. 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

$13.154

Est. ASP / unit

$12.409 est.

Est. after 2% sequester

$12.891

HCPCS dosage

1 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.

🧮 Dosing & billing-units calculator HCPCS UNITS

One billing unit of Q9999 = 1 mg. Enter a regimen to convert dose → billing units and project a full course.

Dose per administration (mg) Frequency — every days Number of doses NDC / package billed (optional)

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 Q9999 WITH EST. MEDICARE PAY

6 NDCs map to Q9999. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($13.154/unit) × that package's bill units.

NDC (11-digit)	Drug	Labeler	Package	Strength	Bill units	Est. pay / pkg	NADAC / unit	Status	Source
65219-0822-05	Otulfi ustekinumab-aauz 45 mg/.5mL INJECTION, SOLUTION	Fresenius	1 VIAL in 1 CARTON (65219-822-05) / .5 mL...	45 mg/.5mL	45	$591.93	—	● Active	CMS ASP
65219-0824-01	Otulfi ustekinumab-aauz 45 mg/.5mL INJECTION, SOLUTION	Fresenius	1 SYRINGE in 1 CARTON (65219-824-01) / .5...	45 mg/.5mL	45	$591.93	—	● Active	CMS ASP
65219-0826-26	Otulfi ustekinumab-aauz 90 mg/mL INJECTION, SOLUTION	Fresenius	1 SYRINGE in 1 CARTON (65219-826-26) / 1...	90 mg/mL	90	$1,183.86	—	● Active	CMS ASP
65219-0828-05	Otulfi ustekinumab-aauz 130 mg/26mL SOLUTION	Fresenius	1 VIAL in 1 CARTON (65219-828-05) / 26 mL...	130 mg/26mL	130	$1,710.02	—	● Active	CMS ASP
65219-0862-01	USTEKINUMAB-AAUZ 45 mg/.5mL INJECTION, SOLUTION	Fresenius	1 SYRINGE in 1 CARTON (65219-862-01) / .5...	45 mg/.5mL	45	$591.93	—	● Active	CMS ASP
65219-0866-26	USTEKINUMAB-AAUZ 90 mg/mL INJECTION, SOLUTION	Fresenius	1 SYRINGE in 1 CARTON (65219-866-26) / 1...	90 mg/mL	90	$1,183.86	—	● Active	CMS ASP

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.

⚠️ Don't confuse Q9999 with… RELATED CODES

Adjacent HCPCS codes that share an ingredient or formulation with Q9999. Billing units and payment limits differ — confirm the exact code, strength and form before billing.

Code	Descriptor	Billing unit	Payment limit / unit	How it differs from Q9999
J3357	Ustekinumab sub cu inj, 1 mg	—	—	Related ingredient or formulation — confirm strength, form and billing unit before substituting.
J3358	Ustekinumab, iv inject, 1 mg	1 MG	$11.356	Related ingredient or formulation — confirm strength, form and billing unit before substituting.
Q5100	USTEKINUMAB-KFCE	1 MG	$3.290	Related ingredient or formulation — confirm strength, form and billing unit before substituting.
Q5099	USTEKINUMAB-STBA	1 MG	$3.075	Related ingredient or formulation — confirm strength, form and billing unit before substituting.

Related codes matched on shared ingredient (CMS Medicare Part B Spending feed). Billing units and payment limits from the CMS ASP Pricing File. Always verify the precise HCPCS code for the product and strength administered.

📈 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

$55.00

Medicare paid

$75.46

Submitted services

16

Denial rate

75.0%

Allowed / service

$13.75

Submitted charges

$320.00

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 Q9999 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.

🗃️ 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

Not available in current dataset

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

6 NDCs mapped

NADAC acquisition cost

CMS National Average Drug Acquisition Cost (weekly)

Not 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.

❓ Q9999 billing FAQ

What is HCPCS code Q9999?

Q9999 is a HCPCS Level II Q-code used to bill Inj ustekinumab-aauz 1 mg under Medicare Part B and most medical (not pharmacy) benefits.

What is the billing unit for Q9999?

One unit of Q9999 represents 1 MG. Report the number of units equal to the dose administered divided by 1 MG.

How many units of Q9999 should I bill?

Divide the dose administered by the code's unit size (1 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 Q9999?

The Medicare Part B payment limit is $13.154 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $12.891 per unit. Payment limits are revised quarterly.

Which NDCs bill under Q9999?

6 NDCs currently map to Q9999 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 Q9999 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.

Q9999 – Inj ustekinumab-aauz 1 mg · NDC Crosswalk & Billing Units