PYZCHIVA Q Code: Q9996

Self-Administered Drug Exclusion 7 Medicare Administrative Contractors list Q9996 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-ttwe (pyzchiva), subcutaneous, 1 mg

HCPCS Added Date January 1, 2025

Manufacturer Cordavis Limited

Route of Administration Subcutaneous

Generic Status Single-Source; Branded

Dosage Form Injection, Solution

About PYZCHIVA

Pyzchiva is a medication aligned to the HCPCS Q Code: Q9996 for billing, pricing, and reimbursement purposes in the United States. It is an Immunology drug administered via the subcutaneous route and manufactured by Cordavis Limited.

Manufacturers, reach out to us to add more information.

NDC Code Information

6 NDC packages are crosswalked to Q9996. Package detail is available to logged-in subscribers.

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

Login to view 6 NDC packages View pricing, complete NDC-to-HCPCS alignments, and package details.

PYZCHIVA Pricing & Reimbursement

Q9996 Private Payer Reimbursement

$46.29 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

Create an account on PayerPrice for more information →

Ustekinumab Biosimilar Information:

PYZCHIVA Approval Date: June 28, 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

PYZCHIVA 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 →

PYZCHIVA Medically Unlikely Edits (MUE)

The most billing units of Q9996 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 1 mg.

Practitioner Office & Hospital Outpatient

90 units / day

= 90 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 →

PYZCHIVA 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 PYZCHIVA billing and coding guide?

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

What are the available PYZCHIVA patient assistance programs?

PYZCHIVA patient assistance information can be found through Sandoz. Visit Here →

Where can I find PYZCHIVA prescribing information?

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

Where can I find PYZCHIVA side effect information?

Our team has not identified a source of side effect information for PYZCHIVA

Does billing PYZCHIVA require JZ/JW wastage modifiers?

CMS does not include PYZCHIVA (Q9996) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing Q9996. For more information, visit the link below.

About BuyandBill.com:

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