Q4074 HCPCS code: Iloprost, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 20 micrograms
Q4074 is the HCPCS Level II code for iloprost, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 20 micrograms. In 2024 Medicare paid an average of $114.99 per service for Q4074 across 4,438 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 279 per day on DME suppliers. Medicare volume fell 89% from 2022 to 2024 (40,727 to 4,438 services). In 2024, 4 suppliers billed Medicare for Q4074 (purchases), serving 0 beneficiaries.
Code details
| Field | Value |
|---|---|
| Section | Q codes — Temporary codes |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 51 — Drug or biological (priced per ASP/average sales price rules) |
| BETOS category | D1G — Drugs administered through DME |
| Added | 2010-01-01 |
| Last action effective | 2010-01-01 |
Who bills Q4074 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 4 |
| Referring clinicians | 9 |
| Medicare beneficiaries | 0 |
| States with claims | 0 |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 10 | 36 |
| 2023 | 4 | 22 |
| 2024 | 4 | 0 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for Q4074, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 40,727 | 36 | $139.87 | $110.57 |
| 2023 | 25,318 | 22 | $141.95 | $111.26 |
| 2024 | 4,438 | 0 | $146.81 | $114.99 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 279 | Clinical: Data |
| practitioner claims | 3 | Clinical: Data |
Medicare policy articles for this code
- A52466: Nebulizers - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
Covered diagnoses (215 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| A15.0 | Tuberculosis of lung | 1 |
| A22.1 | Pulmonary anthrax | 1 |
| A37.01 | Whooping cough due to Bordetella pertussis with pneumonia | 1 |
| A37.11 | Whooping cough due to Bordetella parapertussis with pneumonia | 1 |
| A37.81 | Whooping cough due to other Bordetella species with pneumonia | 1 |
| A37.91 | Whooping cough, unspecified species with pneumonia | 1 |
| A48.1 | Legionnaires' disease | 1 |
| B20 | Human immunodeficiency virus [HIV] disease | 1 |
| B25.0 | Cytomegaloviral pneumonitis | 1 |
| B44.0 | Invasive pulmonary aspergillosis | 1 |
Showing 10 of 215. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for Q4074
- 2010-01-01: Q4074 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code Q4074?
Q4074 is the HCPCS Level II code for iloprost, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 20 micrograms. Short descriptor: "Iloprost non-comp unit dose".
How much does Medicare pay for Q4074?
In 2024, the average Medicare payment was $114.99 per service (average allowed $146.81).
Does Medicare cover Q4074?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for Q4074?
Medicare policy articles that cite Q4074 list 215 covered ICD-10-CM diagnosis codes across 1 article. The most cited include A15.0 (Tuberculosis of lung), A22.1 (Pulmonary anthrax), A37.01 (Whooping cough due to Bordetella pertussis with pneumonia). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
How many units of Q4074 can be billed per day?
279 on DME suppliers; 3 on practitioner claims (NCCI medically unlikely edits).
Related Q40 codes
- Q4001 — Casting supplies, body cast adult, with or without head, plaster ($62.36–$62.36)
- Q4002 — Cast supplies, body cast adult, with or without head, fiberglass ($235.64–$235.64)
- Q4003 — Cast supplies, shoulder cast, adult (11 years +), plaster ($44.78–$44.78)
- Q4004 — Cast supplies, shoulder cast, adult (11 years +), fiberglass ($155.03–$155.03)
- Q4005 — Cast supplies, long arm cast, adult (11 years +), plaster ($16.51–$16.51)
- Q4006 — Cast supplies, long arm cast, adult (11 years +), fiberglass ($37.20–$37.20)
- Q4007 — Cast supplies, long arm cast, pediatric (0-10 years), plaster ($8.25–$8.25)
- Q4008 — Cast supplies, long arm cast, pediatric (0-10 years), fiberglass ($18.59–$18.59)
- Q4009 — Cast supplies, short arm cast, adult (11 years +), plaster ($11.03–$11.03)
- Q4010 — Cast supplies, short arm cast, adult (11 years +), fiberglass ($24.80–$24.80)
- Q4011 — Cast supplies, short arm cast, pediatric (0-10 years), plaster ($5.50–$5.50)
- Q4012 — Cast supplies, short arm cast, pediatric (0-10 years), fiberglass ($12.43–$12.43)
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under Q4074
- Watch Q4074 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for Q4074
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.