Home › Drug Codes › Q Codes › Q9991 · SUBLOCADE
Updated July 1st, 2026

SUBLOCADE Q Code: Q9991

Injection, buprenorphine extended-release (sublocade), less than or equal to 100 mg

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Q4 2026 Medicare Payment Limit for Q9991, effective October 1, 2026: $2,060.132 per HCPCS billing unit, down 0.4% from $2,068.155. From CMS's final file.

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Medicare Payment Limit ?
$2,068.155
/ HCPCS billing unit · Q3 2026
APC Payment Limit ?
$2,068.155
/ HCPCS billing unit · APC 9073
ASP ?
$•••.••
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WAC · AWP ?
$•••.••
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NDCs Crosswalked ?
3
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Drug & Product Overview

HCPCS Descriptor Injection, buprenorphine extended-release (sublocade), less than or equal to 100 mg
HCPCS Added Date July 1, 2018
Manufacturer Indivior
Route of Administration Subcutaneous
Generic Status Single-Source; Branded
Dosage Type Single-Dose
Dosage Form Solution

About SUBLOCADE

Sublocade is a medication aligned to the HCPCS Q Code: Q9991 for billing, pricing, and reimbursement purposes in the United States. Classified under Anti-Addiction, it is administered via the subcutaneous route and manufactured by Indivior.

According to CMS Drug Use Information: Buprenorphine is used to treat opioid use disorder. This long-acting form of buprenorphine should be used after starting treatment with a single dose of a transmucosal form of buprenorphine (one that is used under the tongue or inside the cheek) or after being treated with buprenorphine. Buprenorphine belongs to a class of drugs known as mixed opioid agonist-antagonists. It helps prevent withdrawal symptoms caused by stopping other opioids. It is used as part of a complete treatment program for opioid use disorder (such as compliance monitoring, counseling, behavioral contract, lifestyle changes).

Disclaimer: This is a summary and does not contain all possible information about this product. For complete information about this product or your specific health needs, ask your healthcare professional.

NDC Code Information

Based on publicly available CMS files. Showing 1 of 3 NDCs — log in for the full crosswalk.

NDC Code Drug Manufacturer Billing Units / Pkg Package Size
12496-0100-01 Sublocade Indivior Inc. 1 100 MG
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SUBLOCADE Pricing & Reimbursement

Q9991 Private Payer Reimbursement
$2,012.38 / 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

Buprenorphine Extended-release 505(b)(2) Information:

HCPCS Code Manufacturer Active Ingredient HCPCS Description
J0577 Braeburn Pharmaceutical Buprenorphine Extended-release Injection, buprenorphine extended-release (brixadi), less than or equal to 7 days of therapy
J0578 Braeburn Pharmaceutical Buprenorphine Extended-release Injection, buprenorphine extended release (brixadi), greater than 7 days and up to 28 days of therapy
Q9991 Indivior Buprenorphine Extended-release Injection, buprenorphine extended-release (sublocade), less than or equal to 100 mg
Q9992 Indivior Buprenorphine Extended-release Injection, buprenorphine extended-release (sublocade), greater than 100 mg

SUBLOCADE 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
96372 Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intramuscular
Not on the CMS JW / JZ list

CMS does not include Sublocade (Q9991) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing Q9991. Wastage billing guide →

SUBLOCADE Medically Unlikely Edits (MUE)

The most billing units of Q9991 Medicare will pay for one patient in one day, as published by CMS. 1 unit = less than or equal to 100 mg.

Practitioner Office & Hospital Outpatient
1 unit / day
Same limit in both settings

MAI 2 · Date of Service Edit: Policy. Absolute per-day limit set by policy or regulation; units above it are not payable, and denials are not appealable on medical-necessity grounds. See all MUE limits →

SUBLOCADE 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.

Moderate to severe opioid use disorder
Drug Class
Partial Opioid Agonist [EPC]Partial Opioid Agonists [MoA]

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Frequently Asked Questions

Is there an available Sublocade billing and coding guide?
Billing and coding information for SUBLOCADE can be found through Indivior. Visit Here →
Are there any available Sublocade patient assistance programs?
SUBLOCADE patient assistance information can be found through Indivior. Visit Here →
Where can I find Sublocade prescribing information?
SUBLOCADE prescribing information can be found at the link below: Visit Here →
Where can I find Sublocade side effect information?
Information regarding SUBLOCADE's side effects can be found at MedlinePlus Visit Here →
Does billing SUBLOCADE require JZ/JW wastage modifiers?
CMS does not include SUBLOCADE (Q9991) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing Q9991. For more information, visit the link below.

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Related Drug Codes

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

J0571BUPRENORPHINEBuprenorphine, oral, 1 mgHikmaAdded January 1, 2015J0577BRIXADI (WEEKLY DOSING)Injection, buprenorphine extended-release (brixadi), less than or equal to 7 days of therapyBraeburn PharmaceuticalAdded April 1, 2024J0578BRIXADI (MONTHLY DOSING)Injection, buprenorphine extended release (brixadi), greater than 7 days and up to 28 days of therapyBraeburn PharmaceuticalAdded April 1, 2024Q9992SUBLOCADEInjection, buprenorphine extended-release (sublocade), greater than 100 mgIndiviorAdded July 1, 2018C9154BRIXADIInjection, buprenorphine extended-release (brixadi), 1 mgBraeburn PharmaceuticalAdded October 1, 2023J0576BRIXADIInjection, buprenorphine extended-release (brixadi), 1 mgBraeburn PharmaceuticalAdded January 1, 2024J0592BUPRENEXInjection, buprenorphine hydrochloride, 0.1 mgMultiple ManufacturersAdded January 1, 2003J0570PROBUPHINEBuprenorphine implant, 74.2 mgTitan PharmaceuticalsAdded January 1, 2017J2300NALBUPHINE HCLInjection, nalbuphine hydrochloride, per 10 mgMultiple ManufacturersAdded January 1, 1996J2310NALOXONE HCLInjection, naloxone hydrochloride, per 1 mgMultiple ManufacturersAdded January 1, 1996