The Centers for Medicare and Medicaid Services (CMS) issued product-specific Q-codes for four Eylea biosimilars during Q4-2024 and Q1-2025. Q-codes are billing codes for reimbursement that are similar to J-codes but often specific to biosimilars and wound care products, while J-codes are used to bill for injectable drugs ordinarily not self-administered.

The biosimilars that received Q-codes are Valorum Bio’s Ahzantive, Samsung Bioepis’ Opuviz, Sandoz’ Enzeevu, and Amgen’s Pavblu. All four have gained US approval, but only Pavblu is on the market.

In the first half of 2024, the CMS denied an A-code for the iCare Home2 Tonometer and probes, saying the agency had not identified a specific need for the products to be separately paid, since it believed that a particular payer may elect to pay for the services in which the system were used.

A-codes are used for transportation, medical and surgical supplies, miscellaneous, and experimental treatment.

Ophthalmic Products Gaining US Q-Codes
Applicant	Product	Code	Quarter Issued	Code Description	Target
Amgen	Pavblu	Q5147	Q4-2024	“Injection, aflibercept-ayyh (Pavblu), biosimilar, 1 mg”	Wet age-related macular degeneration (wet AMD), diabetic macular edema (DME), diabetic retinopathy (DR), and macular edema following retinal vein occlusion (ME following RVO)
Sandoz	Enzeevu	Q5149	Q4-2024	“Injection, aflibercept-abzv (Enzeevu), biosimilar, 1 mg”	Wet AMD
Valorum Bio	Ahzantive	Q5150	Q4-2024	“Injection, aflibercept-mrbb (Ahzantive), biosimilar, 1 mg”	Wet AMD, DME, DR, and ME following RVO
Samsung Bioepis	Opuviz	Q5153	Q1-2025	“Injection, aflibercept-yszy (Opuviz), biosimilar, 1 mg.”	Wet AMD, DME, DR, and ME following RVO

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