Question:

The FDA recently approved a biosimilar called Fulphila. Is there a HCPCS code yet for it?

Answer:

The following code will be implemented on October 1, 2018, according to the Centers for Medicare & Medicaid Services (CMS) in MM10834. (For this memo, go to https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM10834.pdf.)

Q5108 Injection, pegfilgrastim-jmdb, biosimilar, (fulphila), 0.5 mg

The code is effective for dates of service on or after July 12, 2018 and will be paid by Medicare.

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