Descriptors and administrative fields exactly as published in the CMS HCPCS quarterly file.
Billing context: Q-codes
Units are reported in multiples of the dosage in the code descriptor.
One HCPCS billing unit of Q4310
100 MG
No published MUE for Q4310. CMS keeps some MUE values confidential, so this does not mean there is no daily unit limit.
Medicare Part B drug payment limits per billing unit, by quarter, from the CMS payment limit (ASP) files.
Most recent Medicare Part B payment limit · Q4 2025
$1,391.605per 100 MG
Effective Oct 1, 2025 – Dec 31, 2025 · ASP methodology (per CMS file) · based on Q2 2025 ASP data · coinsurance 20.000%
Not in the latest payment limit file (Q4 2026). Shown for history only.
| Quarter | Effective | Payment limit | Per (billing unit) | Coinsurance | Change | CMS notes |
|---|---|---|---|---|---|---|
| Q4 2025 | Oct 1, 2025 – Dec 31, 2025 | $1,391.605 | 100 MG | 20% | +5.6% | — |
| Q3 2025 | Jul 1, 2025 – Sep 30, 2025 | $1,317.357 | 100 MG | 20% | −40.5% | — |
| Q2 2025 | Apr 1, 2025 – Jun 30, 2025 | $2,213.138 | 100 MG | 20% | +2.7% | — |
| Q1 2025 | Jan 1, 2025 – Mar 31, 2025 | $2,154.978 | 100 MG |
Medicare hospital outpatient (OPPS) · Q4 2026
N Packaged: no separate payment
Washington Apple Health · professional claims
Not on HCA's professional administered drug fee schedule.
AAC = actual acquisition cost, based on NDC or invoice; BR = by report; NC = not covered; DC = not covered, see a different code; DP = covered under another program (see comments); PA = prior authorization; EPA = expedited prior authorization (see the billing guide); CPA = contractor prior authorization (Qualis). For professional claims; hospital-administered drugs are paid under HCA's outpatient (OPPS/EAPG) rules.
Packages CMS assigns to this code in its NDC–HCPCS crosswalks, with billable units per package. Only official crosswalk rows are shown.
No CMS NDC–HCPCS crosswalk rows were located. CMS notes its crosswalks are not a comprehensive list of all NDCs.
| NDC (11-digit) | CMS drug name · labeler | Pkg size × qty | Units / item | Units / NDC | Crosswalk | Quarters | FDA listing |
|---|---|---|---|---|---|---|---|
| 860004706588 alt ID | ProcentaLUCINA BIOSCIENCES | 1 × 1 | 2 | 2 | ASP | Q2 2024 – Q4 2024Not in Q4 2026 file | Not found |
| 382567001752 alt ID | ProcentaLucina BioSciences, LLC | 1 × 1 | 1 | 1 | ASP | Q4 2024 – Q4 2025Not in Q4 2026 file | Not found |
| 382567001769 alt ID | ProcentaLucina BioSciences, LLC | 1 × 1 | 2 | 2 | ASP | Q4 2024 – Q4 2025Not in Q4 2026 file | Not found |
| 382567001776 alt ID | ProcentaLucina BioSciences, LLC | 1 × 1 | 3 | 3 | ASP | Q4 2024 – Q4 2025Not in Q4 2026 file | Not found |
Medicare coverage is set nationally (NCDs) and by each Medicare Administrative Contractor (LCDs and Billing & Coding articles). These links open the official documents.
Verification neededCodeRx links to coverage documents instead of copying them: CMS distributes their code lists under AMA, ADA, and AHA license terms that limit reuse. Medicare Advantage, Medicaid, and commercial plans set their own coverage and prior-authorization rules.
Changes detected between the CMS quarterly HCPCS files CodeRx has imported.
| Quarterly file | Change | CMS action code | Details |
|---|---|---|---|
| Q1 2026 | Dates changed | P — Payment change | Added Apr 1, 2024 · action effective Jan 1, 2026 · termination — |
| Q2 2024 | Added to HCPCS | A — Added | Added date Apr 1, 2024 |
All imported releases, checksums, and import reports are listed on the data sources page.
Disclaimer. This application provides informational coding and reimbursement reference data. It does not constitute legal, clinical, coding, or billing advice. Codes, payment amounts, payer rules, and coverage policies can change. Verify all information with current CMS publications, the applicable payer, and your organization’s compliance policies before submitting a claim. CodeRx is not affiliated with or endorsed by CMS, FDA, Medicare, or any payer.
| 20% |
| −11.6% |
| — |
| Q4 2024 | Oct 1, 2024 – Dec 31, 2024 | $2,438.326 | 100 MG | 20% | −28.5% | Added October 2024 |
|---|
| Q2 2024 | Apr 1, 2024 – Jun 30, 2024 | $3,409.596 | 100 MG | 20% | — | Added April 2024 |
|---|