Q9965 HCPCS code: Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml
Q9965 is the HCPCS Level II code for low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml. In 2024 Medicare paid an average of $1.08 per service for Q9965 across 2,178,513 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 300 per day on outpatient hospital claims. Medicare volume rose 27% from 2022 to 2024 (1,709,614 to 2,178,513 services). In 2024, about 783 clinicians billed Medicare for Q9965 for 23,773 beneficiaries; Texas, Kentucky, New Jersey accounted for 48% 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 | 2008-01-01 |
| Last action effective | 2008-01-01 |
Who bills Q9965 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 783 |
| Medicare beneficiaries | 23,773 |
| States with claims | 40 |
| Share of services in top 3 states (Texas, Kentucky, New Jersey) | 48% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for Q9965, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 1,709,614 | 24,745 | $0.75 | $0.60 |
| 2023 | 1,513,299 | 23,420 | $1.22 | $0.97 |
| 2024 | 2,178,513 | 23,773 | $1.36 | $1.08 |
States with the most Q9965 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Texas | 421,061 | $1.15 |
| Kentucky | 352,550 | $1.16 |
| New Jersey | 275,793 | $1.10 |
| Ohio | 219,511 | $1.15 |
| Arizona | 211,883 | $1.12 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 300 | Clinical: Data |
| practitioner claims | 250 | Clinical: Data |
What changed for Q9965
- 2008-01-01: Q9965 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 Q9965?
Q9965 is the HCPCS Level II code for low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml. Short descriptor: "Locm 100-199mg/ml iodine,1ml".
How much does Medicare pay for Q9965?
In 2024, the average Medicare payment was $1.08 per service (average allowed $1.36).
Does Medicare cover Q9965?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of Q9965 can be billed per day?
300 on outpatient hospital claims; 250 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
- Q9961 — High osmolar contrast material, 250-299 mg/ml iodine concentration, per ml
- Q9962 — High osmolar contrast material, 300-349 mg/ml iodine concentration, per ml
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Next steps
- Run a reimbursement report for a device billed under Q9965
- Watch Q9965 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for Q9965
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.