| Q5 |
Recip bill arr subs md or pt |
Service furnished under a reciprocal billing arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area |
| Q5001 |
Hospice or home hlth in home |
Hospice or home health care provided in patient's home/residence |
| Q5002 |
Hospice/home hlth in asst lv |
Hospice or home health care provided in assisted living facility |
| Q5003 |
Hospice in lt/non-skilled nf |
Hospice care provided in nursing long term care facility (ltc) or non-skilled nursing facility (nf) |
| Q5004 |
Hospice in snf |
Hospice care provided in skilled nursing facility (snf) |
| Q5005 |
Hospice, inpatient hospital |
Hospice care provided in inpatient hospital |
| Q5006 |
Hospice in hospice facility |
Hospice care provided in inpatient hospice facility |
| Q5007 |
Hospice in ltch |
Hospice care provided in long term care facility |
| Q5008 |
Hospice in inpatient psych |
Hospice care provided in inpatient psychiatric facility |
| Q5009 |
Hospice/home hlth, place nos |
Hospice or home health care provided in place not otherwise specified (nos) |
| Q5010 |
Hospice home care in hospice |
Hospice home care provided in a hospice facility |
| Q5101 |
Injection, zarxio |
Injection, filgrastim-sndz, biosimilar, (zarxio), 1 microgram |
| Q5102 |
Inj., infliximab biosimilar |
Injection, infliximab, biosimilar, 10 mg |
| Q5103 |
Injection, inflectra |
Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg |
| Q5104 |
Injection, renflexis |
Injection, infliximab-abda, biosimilar, (renflexis), 10 mg |
| Q5105 |
Inj retacrit esrd on dialysi |
Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), 100 units |
| Q5106 |
Inj retacrit non-esrd use |
Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units |
| Q5107 |
Inj mvasi 10 mg |
Injection, bevacizumab-awwb, biosimilar, (mvasi), 10 mg |
| Q5108 |
Injection, fulphila |
Injection, pegfilgrastim-jmdb (fulphila), biosimilar, 0.5 mg |
| Q5109 |
Injection, ixifi, 10 mg |
Injection, infliximab-qbtx, biosimilar, (ixifi), 10 mg |
| Q5110 |
Nivestym |
Injection, filgrastim-aafi, biosimilar, (nivestym), 1 microgram |
| Q5111 |
Injection, udenyca 0.5 mg |
Injection, pegfilgrastim-cbqv (udenyca), biosimilar, 0.5 mg |
| Q5112 |
Inj ontruzant 10 mg |
Injection, trastuzumab-dttb, biosimilar, (ontruzant), 10 mg |
| Q5113 |
Inj herzuma 10 mg |
Injection, trastuzumab-pkrb, biosimilar, (herzuma), 10 mg |
| Q5114 |
Inj ogivri 10 mg |
Injection, trastuzumab-dkst, biosimilar, (ogivri), 10 mg |
| Q5115 |
Inj truxima 10 mg |
Injection, rituximab-abbs, biosimilar, (truxima), 10 mg |
| Q5116 |
Inj., trazimera, 10 mg |
Injection, trastuzumab-qyyp, biosimilar, (trazimera), 10 mg |
| Q5117 |
Inj., kanjinti, 10 mg |
Injection, trastuzumab-anns, biosimilar, (kanjinti), 10 mg |
| Q5118 |
Inj., zirabev, 10 mg |
Injection, bevacizumab-bvzr, biosimilar, (zirabev), 10 mg |
| Q5119 |
Inj ruxience, 10 mg |
Injection, rituximab-pvvr, biosimilar, (ruxience), 10 mg |
| Q5120 |
Inj pegfilgrastim-bmez 0.5mg |
Injection, pegfilgrastim-bmez (ziextenzo), biosimilar, 0.5 mg |
| Q5121 |
Inj. avsola, 10 mg |
Injection, infliximab-axxq, biosimilar, (avsola), 10 mg |
| Q5122 |
Inj, nyvepria |
Injection, pegfilgrastim-apgf (nyvepria), biosimilar, 0.5 mg |
| Q5123 |
Inj. riabni, 10 mg |
Injection, rituximab-arrx, biosimilar, (riabni), 10 mg |
| Q5124 |
Inj. byooviz, 0.1 mg |
Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg |
| Q5125 |
Inj, releuko 1 mcg |
Injection, filgrastim-ayow, biosimilar, (releuko), 1 microgram |
| Q5126 |
Inj alymsys 10 mg |
Injection, bevacizumab-maly, biosimilar, (alymsys), 10 mg |
| Q5127 |
Inj, stimufend, 0.5 mg |
Injection, pegfilgrastim-fpgk (stimufend), biosimilar, 0.5 mg |
| Q5128 |
Inj, cimerli, 0.1 mg |
Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg |
| Q5129 |
Inj, vegzelma, 10 mg |
Injection, bevacizumab-adcd (vegzelma), biosimilar, 10 mg |
| Q5130 |
Inj, fylnetra, 0.5 mg |
Injection, pegfilgrastim-pbbk (fylnetra), biosimilar, 0.5 mg |
| Q5131 |
Inj, idacio, 20 mg |
Injection, adalimumab-aacf (idacio), biosimilar, 20 mg |
| Q5132 |
Inj, abrilada, 10 mg |
Injection, adalimumab-afzb (abrilada), biosimilar, 10 mg |
| Q5133 |
Inj, tofidence, 1 mg |
Injection, tocilizumab-bavi (tofidence), biosimilar, 1 mg |
| Q5134 |
Inj, tyruko, 1 mg |
Injection, natalizumab-sztn (tyruko), biosimilar, 1 mg |
| Q5137 |
Inj, wezlana, sub cu, 1 mg |
Injection, ustekinumab-auub (wezlana), biosimilar, subcutaneous, 1 mg |
| Q5138 |
Inj, wezlana, iv, 1 mg |
Injection, ustekinumab-auub (wezlana), biosimilar, intravenous, 1 mg |
