CMS Part B Biosimilar Biological Product Payment and Required Modifiers
On January 26th, 2016
The table below lists the current biosimilar HCPCS Codes, the product(s) that are associated with each code and the corresponding required modifier that is used to identify the product. The table will be updated quarterly when new permanent HCPCS codes and modifiers are available for biosimilar products that appear on the ASP price file. Please note that the determination of the payment about for biosimilars is not affected by the use of a modifier. For more information, visit the CMS site, CLICK HERE.
Biosimilar HCPCS Code
Product Brand names
Corresponding Required Modifier
Q5101 Injection, Filgrastim (G-CSF), Biosimilar, 1 microgram
Zarxio
ZA- Novartis/Sandoz
The table below lists the current biosimilar HCPCS Codes, the product(s) that are associated with each code and the corresponding required modifier that is used to identify the product. The table will be updated quarterly when new permanent HCPCS codes and modifiers are available for biosimilar products that appear on the ASP price file. Please note that the determination of the payment about for biosimilars is not affected by the use of a modifier. For more information, visit the CMS site, CLICK HERE.
| Biosimilar HCPCS Code | Product Brand names | Corresponding Required Modifier |
| Q5101 Injection, Filgrastim (G-CSF), Biosimilar, 1 microgram | Zarxio | ZA- Novartis/Sandoz |
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