CYLTEZO Q Code: Q5143

Self-Administered Drug Exclusion 7 Medicare Administrative Contractors list Q5143 as usually self-administered and exclude it from Part B coverage in their jurisdictions. Check the article for your MAC before billing: CGS, First Coast, Noridian (A53032), Noridian (A53033), Novitas, Palmetto, Wellpoint Federal, WPS · All SAD lists →

Drug & Product Overview

HCPCS Descriptor Injection, adalimumab-adbm, biosimilar, 1 mg

HCPCS Added Date January 1, 2025

Manufacturer Boehringer Ingelheim

Route of Administration Subcutaneous

Generic Status Single-Source; Branded

Dosage Type Single-Dose

Dosage Form Kit

About CYLTEZO

Cyltezo is a medication aligned to the HCPCS Q Code: Q5143 for billing, pricing, and reimbursement purposes in the United States. Classified under Immunology: Anti-TNF, it is administered via the subcutaneous route and manufactured by Boehringer Ingelheim.

Manufacturers, reach out to us to add more information.

NDC Code Information

23 NDC packages are crosswalked to Q5143. Package detail is available to logged-in subscribers.

NDC Code	Drug	Manufacturer	Billing Units / Pkg	Package Size
•••••-••••-•• Log in to view	CYLTEZO
	CYLTEZO
	CYLTEZO
	CYLTEZO

Login to view 23 NDC packages View pricing, complete NDC-to-HCPCS alignments, and package details.

CYLTEZO Pricing & Reimbursement

Q5143 Private Payer Reimbursement

$44.42 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

Create an account on PayerPrice for more information →

Adalimumab Biosimilar Information:

CYLTEZO Approval Date: August 25, 2017

Product Name	HCPCS Code	Active Ingredient	BLA Type
Humira	J0139	Adalimumab	351(a) Originator Product
Amjevita	N/A	Adalimumab	351(k) Interchangeable
Cyltezo	Q5143	Adalimumab	351(k) Interchangeable
Hyrimoz	N/A	Adalimumab	351(k) Interchangeable
Hadlima	N/A	Adalimumab	351(k) Interchangeable
Abrilada	Q5145	Adalimumab	351(k) Interchangeable
Hulio	Q5140	Adalimumab	351(k) Interchangeable
Yusimry	N/A	Adalimumab	351(k) Biosimilar
Idacio	Q5144	Adalimumab	351(k) Biosimilar
Yuflyma	Q5141	Adalimumab	351(k) Interchangeable
Simlandi	Q5142	Adalimumab	351(k) Interchangeable

CYLTEZO CPT Administration Codes

CPT Code	Description
96372	Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intramuscular

Not on the CMS JW / JZ list

This product is new and does not yet appear on the CMS list of HCPCS pertaining to single-dose containers. Wastage billing guide →

CYLTEZO Medically Unlikely Edits (MUE)

The most billing units of Q5143 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 1 mg.

Practitioner Office & Hospital Outpatient

160 units / day

= 160 mg per day

MAI 3 · Date of Service Edit: Clinical. Per-day limit based on clinical expectations; excess units are denied but may be appealed with documentation of medical necessity. See all MUE limits →

CYLTEZO Clinical Information

Indications and drug classification.

Treated Diseases & Conditions

This list of indications is not exhaustive and may be subject to errors. The information on BuyandBill.com is intended for informational purposes only and should not be used for medical advice.

Ankylosing Spondylitis Crohn's Disease Hidradenitis Suppurativa Juvenile Idiopathic Arthritis Plaque Psoriasis Psoriatic Arthritis Rheumatoid Arthritis Ulcerative Colitis Uveitis

Frequently Asked Questions

Is there an available CYLTEZO billing and coding guide?

Our team has not identified a manufacturer-published source of billing and coding information for CYLTEZO.

What are the available CYLTEZO patient assistance programs?

CYLTEZO patient assistance information can be found through Boehringer Ingelheim. Visit Here →

Where can I find CYLTEZO prescribing information?

CYLTEZO prescribing information can be found at the link below. Visit Here →

Where can I find CYLTEZO side effect information?

CYLTEZO side effect information can be found through MedlinePlus at the link below.

Does billing CYLTEZO require JZ/JW wastage modifiers?

CMS does not include CYLTEZO (Q5143) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing Q5143. For more information, visit the link below.

About BuyandBill.com:

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