Drugs and Biologicals, Coverage of, for Label and Off-Label Uses
J6 · Effective Oct 1, 2015
3 active Medicare policies list Q5152, and 13 commercial payer policies list it. See each policy's status for the code and its official source. Listing a code is not a coverage decision: read each policy’s source for the requirements that apply.
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J6 · Effective Oct 1, 2015
JK · Effective Oct 1, 2015
J6 · Effective Apr 1, 2026
13 policies from 7 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of Q5152 |
|---|---|---|
| Eculizumab and Associated Biosimilar(s) | Dec 1, 2025 | Covered |
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Policy | Effective | Status of Q5152 |
|---|---|---|
| Eculizumab and Associated Biosimilar(s) | Dec 1, 2025 | Covered |
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Policy | Effective | Status of Q5152 |
|---|---|---|
| Eculizumab and Associated Biosimilar(s) | Dec 1, 2025 | Covered |
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Policy | Effective | Status of Q5152 |
|---|---|---|
| Eculizumab and Associated Biosimilar(s) | Dec 1, 2025 | Covered |
| Specialty Medication Administration Site of Care | Jan 1, 2026 | Covered |
| Policy | Effective | Status of Q5152 |
|---|---|---|
| Complement C5 Inhibitors | Apr 1, 2026 | Covered |
| Provider Administered Drugs – Site of Care | Oct 1, 2026 | Covered |
| Policy | Effective | Status of Q5152 |
|---|---|---|
| Complement C5 Inhibitors | Apr 1, 2026 | Covered |
| Provider Administered Drugs – Site of Care | Oct 1, 2026 | Covered |
| Policy | Effective | Status of Q5152 |
|---|---|---|
| Complement C5 Inhibitors | Apr 1, 2026 | Covered |