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HCPCS Q9950 · Level II · Part B drug

HCPCS Q9950: Injection, sulfur hexafluoride lipid microspheres, per ml

Reviewed by QuickIntell RCM Editorial Team · Last reviewed

Data effective
Data currency: ASP payment limits October 2026 (effective October 1, 2026); MUE and NCCI edits 2026 Q4 (effective October 1, 2026); OPPS Addendum B July 2026 (effective July 1, 2026). Next CMS release: January 1, 2027 (ASP, MUE, NCCI and OPPS quarterly updates).

Key facts for Q9950

Billing unit
1 ML
Inj sulf hexa lipid microsph
ASP payment limit
$18.052
October 2026; -0.4% vs July 2026
Practitioner MUE
5
MAI 3
OPPS status
SI N
NCCI exposure
no PTP pairs
Coverage articles
1
4 states

TL;DR

HCPCS Q9950 is the Level II code for Injection, sulfur hexafluoride lipid microspheres, per ml, billed per 1 ML. The Medicare Part B ASP payment limit for October 2026 is $18.052 per billing unit, down 0.4% from July 2026. The practitioner MUE allows up to 5 units per date of service (MAI 3). Under OPPS it carries status indicator N. Diagnostic agents are usually packaged under OPPS (status N) in the hospital outpatient setting, so separate payment applies mainly in the physician office under Part B. The ASP crosswalk maps 4 NDCs to it, sold as Lumason, Lumason Novaplus by Bracco Diagnostics Inc.. 1 Medicare coverage article lists the code across 4 states, including .

Medicare Part B payment limit (ASP)

CMS sets the Part B payment limit for Q9950 at $18.052 per 1 ML for October 2026, derived from manufacturer average sales price plus 6%, compared with $18.126 in July 2026. Beneficiary coinsurance is 20%.

ASP payment limits for Q9950
QuarterPayment limitPerCoinsurance
October 2026$18.0521 ML20%
July 2026$18.1261 ML—
Source: CMS Medicare Part B Drug Payment Limit File. Commercial and Medicaid payers set their own rates.

NDC to HCPCS billing-unit conversion

The October 2026 ASP crosswalk maps 4 NDCs from 1 labeler to Q9950. Report the NDC in the claim's drug segment and bill the number of Q9950 units that equals the quantity administered divided by 1 ML; the last column gives units per full package.

NDCs that crosswalk to Q9950
NDCDrug nameLabelerPackage sizeBilling units / package
00270-7097-07LumasonBracco Diagnostics Inc.5 × 20100
00270-7097-08Lumason NovaplusBracco Diagnostics Inc.5 × 20100
00270-7099-16LumasonBracco Diagnostics Inc.5 × 525
00270-7099-73Lumason NovaplusBracco Diagnostics Inc.5 × 525

Medically Unlikely Edits (MUE)

CMS publishes 2 MUE values for Q9950. For practitioners the limit is 5 units per date of service with adjudication indicator 3, a date-of-service clinical edit: units above the limit deny but can be paid on appeal with documentation that the quantity was medically reasonable.

MUE values for Q9950 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services53 Date of Service Edit: ClinicalCMS Policy
Facility outpatient hospital53 Date of Service Edit: ClinicalCMS Policy

NCCI edits and add-on relationships

No active practitioner PTP pair lists Q9950 as a column-1 or column-2 code in v323r0. Drug supply codes are rarely bundled; the administration codes billed with them are where PTP edits usually apply.

Q9950 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.

Medicare coverage articles

1 current Medicare Administrative Contractor article lists Q9950 in their HCPCS tables, covering 4 states. Each article carries the covered and non-covered ICD-10 codes that medical-necessity denials (CARC 50) are adjudicated against.

Billing and Coding Articles listing Q9950
ArticleTitleContractor(s)StatesRelated LCD
Billing and Coding: Echocardiography for Myocardial PerfusionPalmetto GBANC SC VA WVL38786

Hospital outpatient (OPPS) status

In the July 2026 OPPS Addendum B, Q9950 carries status indicator N. Status N means payment is packaged into the associated procedure and no separate OPPS payment is made.

Common denials for Q9950 and how to prevent them

CARC 16 · M119

NDC missing, invalid or not matched to the HCPCS code

CARC 151 · N362

units billed exceed the MUE for the date of service

CARC 50 · N115

diagnosis not covered by the applicable coverage article or LCD

How QuickIntell checks Q9950 before the claim leaves

QuickCode validates the NDC-to-unit conversion against the current ASP crosswalk, checks units against every published MUE setting and flags PTP and add-on conflicts on the same claim. QuickRCM routes CARC 16, 151 and 50 denials on drug lines with the matching coverage article attached so the appeal starts with evidence.

Explore QuickCodeExplore QuickRCMBook a demo

Frequently asked questions — HCPCS Q9950

What does HCPCS code Q9950 describe?

Q9950 is defined by CMS as "Injection, sulfur hexafluoride lipid microspheres, per ml". Each billing unit represents 1 ML, so the units reported on the claim must equal the dose administered divided by that unit.

What is the Medicare reimbursement for Q9950 in October 2026?

The ASP-based payment limit is $18.052 per 1 ML, with 20% beneficiary coinsurance. Medicare Administrative Contractors apply this limit; commercial payers use their own fee schedules. The July 2026 limit was $18.126.

How many units of Q9950 can be billed per day?

The practitioner Medically Unlikely Edit is 5 units per date of service with adjudication indicator 3 (3 Date of Service Edit: Clinical). MAI 3 edits can be appealed with documentation that the units were medically reasonable. CMS cites "CMS Policy" as the rationale.

Which NDCs map to Q9950?

The October 2026 ASP crosswalk lists 4 NDCs from 1 labeler: Lumason (Bracco Diagnostics Inc.); Lumason Novaplus (Bracco Diagnostics Inc.). For example NDC 00270-7097-07 is a 5 package equal to 100 billing units. The crosswalk's billing-units-per-package figure converts each package into Q9950 units.

Does Q9950 have NCCI bundling edits?

No active practitioner PTP pairs list Q9950 as a column-1 or column-2 code in the v323r0 release. Unit limits (MUE) and medical-necessity coverage rules still apply.

Which Medicare coverage articles mention Q9950?

1 current Billing and Coding Article in the Medicare Coverage Database list Q9950, covering 4 states: (Billing and Coding: Echocardiography for Myocardial Perfusion).

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-01. Verify against the primary file before billing or contracting decisions.

Disclaimer

This page is an operational reference compiled from CMS publications: the Medicare Part B drug payment limit and NDC crosswalk files, NCCI MUE and add-on edit tables, aggregate PTP statistics, OPPS Addendum B and the Medicare Coverage Database. Payment limits are Medicare national amounts; commercial and Medicaid payers differ. CPT codes are shown as numbers only; CPT descriptors are copyright AMA. Nothing here is legal, clinical or billing advice.