Q9997 HCPCS code: Injection, ustekinumab-ttwe (pyzchiva), intravenous, 1 mg
Q9997 is the HCPCS Level II code for injection, ustekinumab-ttwe (pyzchiva), intravenous, 1 mg. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 520 per day on DME suppliers.
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 | 2025-01-01 |
| Last action effective | 2025-01-01 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 520 | Prescribing Information |
| outpatient hospital claims | 520 | Prescribing Information |
| practitioner claims | 520 | Prescribing Information |
What changed for Q9997
- 2025-01-01: Q9997 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 Q9997?
Q9997 is the HCPCS Level II code for injection, ustekinumab-ttwe (pyzchiva), intravenous, 1 mg. Short descriptor: "Ustekinumab-ttwe iv inj 1 mg".
Does Medicare cover Q9997?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of Q9997 can be billed per day?
520 on DME suppliers; 520 on outpatient hospital claims; 520 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 Q9997
- Watch Q9997 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for Q9997
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.