Home › Drug Codes › Q Codes › Q9999 · Otulfi
Updated July 1st, 2026

Otulfi Q Code: Q9999

Injection, ustekinumab-aauz (otulfi), biosimilar, 1 mg

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Q4 2026 Medicare Payment Limit for Q9999, effective October 1, 2026: $13.246 per HCPCS billing unit, up 0.7% from $13.154. From CMS's final file.

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Medicare Payment Limit ?
$13.154
/ HCPCS billing unit · Q3 2026
APC Payment Limit ?
$13.154
/ HCPCS billing unit · APC 0895
ASP ?
$•••.••
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WAC · AWP ?
$•••.••
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NDCs Crosswalked ?
6
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Self-Administered Drug Exclusion 7 Medicare Administrative Contractors list Q9999 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-aauz (otulfi), biosimilar, 1 mg
HCPCS Added Date April 1, 2025
Manufacturer Fresenius Kabi
Route of Administration Intravenous, Subcutaneous
Generic Status Single-Source; Branded
Dosage Form Injection, Solution | Solution

About Otulfi

Otulfi is a medication aligned to the HCPCS Q Code: Q9999 for billing, pricing, and reimbursement purposes in the United States. It is an Immunology drug administered via the intravenous or subcutaneous routes and manufactured by Fresenius Kabi.

Manufacturers, reach out to us to add more information.

NDC Code Information

Based on publicly available CMS files. Showing 5 of 6 NDCs — log in for the full crosswalk.

NDC Code Drug Manufacturer Billing Units / Pkg Package Size
65219-0822-05 Otulfi Fresenius Kabi USA, LLC 45 45 MG / 0.5 ML
65219-0824-01 Otulfi Fresenius Kabi USA, LLC 45 45 MG / 0.5 ML
65219-0826-26 Otulfi Fresenius Kabi USA, LLC 90 90 MG / 1 ML
65219-0828-05 Otulfi Fresenius Kabi USA, LLC 130 130 MG / 26 ML
65219-0862-01 Ustekinumab-Aauz Fresenius Kabi USA, LLC 45 45 MG / 0.5 ML
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Otulfi Pricing & Reimbursement

Q9999 Private Payer Reimbursement
$32.75 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

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UnitedHealthcare, BlueCross BlueShield, Aetna, Cigna

Historical Graphing and Billing Calculator

per HCPCS unit
As of Q3 2026

Ustekinumab Biosimilar Information:

Otulfi Approval Date: September 27, 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

Otulfi CPT Administration Codes

The below list of CPT codes is intended for informational purposes only and may not be exhaustive. CPT® codes and descriptions are copyright American Medical Association (AMA). All rights reserved.

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)
96372 Login for More Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intramuscular Login for More
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 →

Otulfi Medically Unlikely Edits (MUE)

The most billing units of Q9999 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 →

mg Enter a dose to see how many billing units it is and whether it is under the limit.

Otulfi 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]

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Frequently Asked Questions

Is there an available Otulfi billing and coding guide?
Billing and coding information for Otulfi can be found through FreseniUS Kabi USA, LLC. Visit Here →
Are there any available Otulfi patient assistance programs?
Otulfi patient assistance information can be found through FreseniUS Kabi USA, LLC. Visit Here →
Where can I find Otulfi prescribing information?
Otulfi prescribing information can be found at the link below. Visit Here →
Where can I find Otulfi side effect information?
Information regarding Otulfi's side effects can be found at MedlinePlus. Visit Here →
Does billing Otulfi require JZ/JW wastage modifiers?
This product is new and does not yet appear on the CMS list of HCPCS pertaining to single-dose containers.

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Related Drug Codes

Explore billing, coding, and pricing for drugs related to Otulfi.

J3358STELARAUstekinumab, for intravenous injection, 1 mgJanssenAdded January 1, 2018Q5098IMULDOSAInjection, ustekinumab-srlf (imuldosa), biosimilar, 1 mgAccordAdded July 1, 2025Q5099STEQEYMAInjection, ustekinumab-stba (steqeyma), biosimilar, 1 mgCelltrion USAAdded July 1, 2025Q5100YESINTEKInjection, ustekinumab-kfce (yesintek), biosimilar, 1 mgBiocon Biologics IncAdded July 1, 2025Q5137WezlanaInjection, ustekinumab-auub (wezlana), biosimilar, subcutaneous, 1 mgNuvailaAdded July 1, 2024Q5164StarjemzaInjection, ustekinumab-hmny (starjemza), biosimilar, 1 mgHikmaAdded July 1, 2026J3357STELARAUstekinumab, for subcutaneous injection, 1 mgJanssenAdded January 1, 2011J0139HUMIRAInjection, adalimumab, 1 mgAbbvieAdded January 1, 2025J0717CIMZIAInjection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)UCB PharmaAdded January 1, 2014J1628TREMFYAInjection, guselkumab, 1 mgJanssenAdded January 1, 2019