IMULDOSA Q Code: Q5098

Self-Administered Drug Exclusion 7 Medicare Administrative Contractors list Q5098 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, ustekinumab-srlf (imuldosa), biosimilar, 1 mg

HCPCS Added Date July 1, 2025

Manufacturer Accord

Route of Administration Intravenous, Subcutaneous

Generic Status Single-Source; Branded

Dosage Type Single-Dose

Dosage Form Injection

About IMULDOSA

Imuldosa is a medication aligned to the HCPCS Q Code: Q5098 for billing, pricing, and reimbursement purposes in the United States. Classified under Immunology, it is administered via the intravenous or subcutaneous routes and manufactured by Accord.

Manufacturers, reach out to us to add more information.

NDC Code Information

Based on publicly available CMS files. The list of NDCs below is not exhaustive.

NDC Code	Package	Manufacturer	HCPCS Units	WAC	AWP
69448-0017-63	45 MG / 0.5 ML Imuldosa Subcutaneous Injection 45 MG/0.5ML - 1 BLISTER PACK in 1 CARTON (69448-017-63) / 1 SYRINGE in 1 BLISTER PACK / .5 mL in 1 SYRINGE	Accord BioPharma Inc.	45	$1,166.06 $25.912 / unit	$1,399.27 $31.095 / unit
69448-0018-63	90 MG / 1 ML Imuldosa Subcutaneous Injection 90 MG/1ML - 1 BLISTER PACK in 1 CARTON (69448-018-63) / 1 SYRINGE in 1 BLISTER PACK / 1 mL in 1 SYRINGE	Accord BioPharma Inc.	90	$2,332.12 $25.912 / unit	$2,798.54 $31.095 / unit
69448-0019-26	130 MG / 26 ML Imuldosa Intravenous Injection 130 MG/26ML - 1 VIAL, SINGLE-USE in 1 CARTON (69448-019-26) / 26 mL in 1 VIAL, SINGLE-USE	Accord BioPharma Inc.	130	$1,483.76 $11.414 / unit	$1,780.51 $13.696 / unit

Effective 7/2/25 (WAC & AWP)

Login for the full NDC crosswalk View pricing, complete NDC-to-HCPCS alignments, and package details.

IMULDOSA Pricing & Reimbursement

Q5098 Private Payer Reimbursement

$8.92 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

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Historical Graphing and Billing Calculator

NDC Package

HCPCS Units

Markup / Markdown

Common:

Estimates only. Payer reimbursement varies by contract, site of care, and sequestration.

Estimated Reimbursement

Ustekinumab Biosimilar Information:

IMULDOSA Approval Date: October 10, 2024

Product Name	HCPCS Code	Active Ingredient	BLA Type
Stelara	J3358	Ustekinumab	351(a) Originator Product
Wezlana	Q5137	Ustekinumab	351(k) Interchangeable
Wezlana	Q5138	Ustekinumab	351(k) Interchangeable
Selarsdi	Q9998	Ustekinumab	351(k) Interchangeable
Pyzchiva	Q9996	Ustekinumab	351(k) Interchangeable
Pyzchiva	Q9997	Ustekinumab	351(k) Interchangeable
Otulfi	Q9999	Ustekinumab	351(k) Interchangeable
Imuldosa	Q5098	Ustekinumab	351(k) Interchangeable
Yesintek	Q5100	Ustekinumab	351(k) Interchangeable
Steqeyma	Q5099	Ustekinumab	351(k) Interchangeable
Starjemza	Q5164	Ustekinumab	351(k) Interchangeable

IMULDOSA CPT Administration Codes

CPT Code	Description
96365	Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour
96366	Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); each additional hour (List separately in addition to code for primary procedure)
96401	Chemotherapy administration, subcutaneous or intramuscular; non-hormonal anti-neoplastic

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 →

IMULDOSA Medically Unlikely Edits (MUE)

The most billing units of Q5098 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 1 mg.

Practitioner Office & Hospital Outpatient

520 units / day

= 520 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 →

IMULDOSA 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.

Crohn's Disease Plaque Psoriasis Psoriatic Arthritis Ulcerative Colitis

Drug Class

Interleukin-12 Antagonist [EPC]Interleukin-12 Antagonists [MoA]Interleukin-23 Antagonist [EPC]Interleukin-23 Antagonists [MoA]

Frequently Asked Questions

Is there an available IMULDOSA billing and coding guide?

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

Are there any available IMULDOSA patient assistance programs?

IMULDOSA patient assistance information can be found through Accord Biopharma. Visit Here →

Where can I find IMULDOSA prescribing information?

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

Where can I find IMULDOSA side effect information?

Side effect information for IMULDOSA can be found through MedlinePlus. Visit Here →

Does billing IMULDOSA require JZ/JW wastage modifiers?

CMS does not include IMULDOSA (Q5098) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing Q5098. For more information, visit the link below.

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