HCPCS code Q5133 — Inj, tofidence, 1 mg. Status: Active. Effective Oct 1, 2024. Source: CMS HCPCS Level II.

Q5133

Active

Inj, tofidence, 1 mg

Injection, tocilizumab-bavi (tofidence), biosimilar, 1 mg

Category: Temporary
Section: Q-codes: Temporary Codes
Effective: Oct 1, 2024
Code type: alphanumeric
OPPS Status: G — Pass-through drugs and biologicals
OPPS APC: 0786

MUE — Medically Unlikely Edits

Maximum units of Q5133 Medicare will pay for one beneficiary on one date of service. Claims exceeding the MUE are denied or returned for review.

Service Type Max Units / Day
DME Supplier 1200
Outpatient Hospital 1200
Practitioner Services 1200

Source: CMS Medicare NCCI Medically Unlikely Edits

NDC Crosswalk

National Drug Codes (NDCs) mapped to this HCPCS code.

NDC Drug Name
64406-0022-01 Tofidence
64406-0023-01 Tofidence
64406-0024-01 Tofidence

Change History

Quarterly changes published by CMS. Revisions may affect the code description, coverage, or rate — review each quarter's changes before submitting claims.

  • New Code 2024-Q4
    Inj, tofidence, 1 mg