Q9961 HCPCS code: High osmolar contrast material, 250-299 mg/ml iodine concentration, per ml
Q9961 is the HCPCS Level II code for high osmolar contrast material, 250-299 mg/ml iodine concentration, per ml. In 2024 Medicare paid an average of $0.21 per service for Q9961 across 11,740 services. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. The NCCI unit limit is 200 per day on outpatient hospital claims. Medicare volume fell 47% from 2022 to 2024 (22,277 to 11,740 services). In 2024, about 50 clinicians billed Medicare for Q9961 for 400 beneficiaries; California, North Carolina, Missouri accounted for 79% of services.
Code details
| Field | Value |
|---|---|
| Section | Q codes — Temporary codes |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 51 — Drug or biological (priced per ASP/average sales price rules) |
| BETOS category | I1E |
| Added | 2005-07-01 |
| Last action effective | 2005-07-01 |
Who bills Q9961 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 50 |
| Medicare beneficiaries | 400 |
| States with claims | 9 |
| Share of services in top 3 states (California, North Carolina, Missouri) | 79% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for Q9961, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 22,277 | 859 | $0.24 | $0.18 |
| 2023 | 12,603 | 688 | $0.18 | $0.14 |
| 2024 | 11,740 | 400 | $0.27 | $0.21 |
States with the most Q9961 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 3,150 | $0.24 |
| North Carolina | 2,881 | $0.21 |
| Missouri | 2,570 | $0.20 |
| Arizona | 1,318 | $0.21 |
| Nevada | 510 | $0.20 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 200 | Prescribing Information |
| practitioner claims | 200 | Prescribing Information |
What changed for Q9961
- 2005-07-01: Q9961 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 Q9961?
Q9961 is the HCPCS Level II code for high osmolar contrast material, 250-299 mg/ml iodine concentration, per ml. Short descriptor: "Hocm 250-299mg/ml iodine,1ml".
How much does Medicare pay for Q9961?
In 2024, the average Medicare payment was $0.21 per service (average allowed $0.27).
Does Medicare cover Q9961?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of Q9961 can be billed per day?
200 on outpatient hospital claims; 200 on practitioner claims (NCCI medically unlikely edits).
Related Q99 codes
- Q9950 — Injection, sulfur hexafluoride lipid microspheres, per ml
- Q9951 — Low osmolar contrast material, 400 or greater mg/ml iodine concentration, per ml
- Q9953 — Injection, iron-based magnetic resonance contrast agent, per ml
- Q9954 — Oral magnetic resonance contrast agent, per 100 ml
- Q9955 — Injection, perflexane lipid microspheres, per ml
- Q9956 — Injection, octafluoropropane microspheres, per ml
- Q9957 — Injection, perflutren lipid microspheres, per ml
- Q9958 — High osmolar contrast material, up to 149 mg/ml iodine concentration, per ml
- Q9959 — High osmolar contrast material, 150-199 mg/ml iodine concentration, per ml
- Q9960 — High osmolar contrast material, 200-249 mg/ml iodine concentration, per ml
- Q9962 — High osmolar contrast material, 300-349 mg/ml iodine concentration, per ml
- Q9963 — High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml
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 Q9961
- Watch Q9961 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for Q9961
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.