Q9991 HCPCS code: Injection, buprenorphine extended-release (sublocade), less than or equal to 100 mg
Q9991 is the HCPCS Level II code for injection, buprenorphine extended-release (sublocade), less than or equal to 100 mg. In 2024 Medicare paid an average of $904.01 per service for Q9991 across 323 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 1 per day on outpatient hospital claims. Medicare volume rose 47% from 2022 to 2024 (220 to 323 services). In 2024, about 77 clinicians billed Medicare for Q9991 for 72 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 | O1E — Other drugs |
| Added | 2018-07-01 |
| Last action effective | 2018-07-01 |
Who bills Q9991 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 77 |
| Medicare beneficiaries | 72 |
| States with claims | 1 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for Q9991, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 220 | 61 | $1,495.54 | $1,188.93 |
| 2023 | 275 | 68 | $1,460.97 | $1,157.76 |
| 2024 | 323 | 72 | $1,140.01 | $904.01 |
States with the most Q9991 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Massachusetts | 79 | $788.89 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 1 | Code Descriptor / CPT Instruction |
| practitioner claims | 1 | Code Descriptor / CPT Instruction |
What changed for Q9991
- 2018-07-01: Q9991 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 Q9991?
Q9991 is the HCPCS Level II code for injection, buprenorphine extended-release (sublocade), less than or equal to 100 mg. Short descriptor: "Buprenorph xr 100 mg or less".
How much does Medicare pay for Q9991?
In 2024, the average Medicare payment was $904.01 per service (average allowed $1,140.01).
Does Medicare cover Q9991?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of Q9991 can be billed per day?
1 on outpatient hospital claims; 1 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 Q9991
- Watch Q9991 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for Q9991
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.