SIMLANDI Q Code: Q5142

Self-Administered Drug Exclusion 7 Medicare Administrative Contractors list Q5142 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-ryvk biosimilar, 1 mg

HCPCS Added Date January 1, 2025

Manufacturer Teva

Route of Administration Subcutaneous

Generic Status Single-Source; Branded

Dosage Type Single-Dose

Dosage Form Kit

About SIMLANDI

Simlandi is a medication aligned to the HCPCS Q Code: Q5142 for billing, pricing, and reimbursement purposes in the United States. It is an Immunology: Anti-TNF drug administered via the subcutaneous route and manufactured by Teva.

Manufacturers, reach out to us to add more information.

NDC Code Information

11 NDC packages are crosswalked to Q5142. Package detail is available to logged-in subscribers.

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

Login to view 11 NDC packages View pricing, complete NDC-to-HCPCS alignments, and package details.

SIMLANDI Pricing & Reimbursement

Q5142 Private Payer Reimbursement

$12.80 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

Create an account on PayerPrice for more information →

Adalimumab Biosimilar Information:

SIMLANDI Approval Date: February 23, 2024

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

SIMLANDI 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 →

SIMLANDI Medically Unlikely Edits (MUE)

The most billing units of Q5142 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 →

SIMLANDI 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 Non-infectious intermediate, posterior, and panuveitis Plaque Psoriasis Psoriatic Arthritis Rheumatoid Arthritis Ulcerative Colitis Uveitis

Frequently Asked Questions

Is there an available SIMLANDI billing and coding guide?

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

What are the available SIMLANDI patient assistance programs?

SIMLANDI patient assistance information can be found through Teva Pharmaceuticals USA. Visit Here →

Where can I find SIMLANDI prescribing information?

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

Where can I find SIMLANDI side effect information?

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

Does billing SIMLANDI require JZ/JW wastage modifiers?

CMS does not include SIMLANDI (Q5142) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing Q5142. For more information, visit the link below.

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