`Q0162` Ondansetron oral

Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen

Medicare coverage: Special coverage instructions apply
Status: active (October 2026 file)

Medically Unlikely Edits (effective October 1, 2026)

Practitioner: max 0 units per day (clinical), rationale: Oral Medication; Not Payable
Outpatient hospital: max 24 units per day (clinical), rationale: Prescribing Information
DME supplier: max 40 units per day (clinical), rationale: CMS Policy

Medicare pricing for Q0162

Medicare Part B drug payment limit (ASP, October 2026)

Q0162 payment limit: $0.016 per 1 MG, effective October 1, 2026 through December 31, 2026, based on 2Q26 ASP data. Coinsurance 20%.

NDCs that bill under Q0162 (CMS ASP NDC-HCPCS crosswalk, October 2026)

50090-3185-01 Ondansetron, A-S Medication Solutions: 80 billing units per package (10 TABLET, FILM COATED in 1 BOTTLE, PLASTIC)
50090-3185-02 Ondansetron, A-S Medication Solutions: 24 billing units per package (3 TABLET, FILM COATED in 1 BOTTLE, PLASTIC)
50090-3185-03 Ondansetron, A-S Medication Solutions: 240 billing units per package (30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC)
50090-3185-04 Ondansetron, A-S Medication Solutions: 48 billing units per package (6 TABLET, FILM COATED in 1 BOTTLE, PLASTIC)
50090-3769-00 Ondansetron, A-S Medication Solutions: 32 billing units per package
50090-3769-01 Ondansetron, A-S Medication Solutions: 80 billing units per package
50090-3769-03 Ondansetron, A-S Medication Solutions: 240 billing units per package
50090-3769-04 Ondansetron, A-S Medication Solutions: 48 billing units per package
50090-4671-00 Ondansetron, A-S Medication Solutions: 32 billing units per package (4 TABLET, FILM COATED in 1 BOTTLE)
50090-4671-01 Ondansetron, A-S Medication Solutions: 80 billing units per package (10 TABLET, FILM COATED in 1 BOTTLE)
50090-4671-02 Ondansetron, A-S Medication Solutions: 24 billing units per package (3 TABLET, FILM COATED in 1 BOTTLE)
50090-4671-03 Ondansetron, A-S Medication Solutions: 240 billing units per package (30 TABLET, FILM COATED in 1 BOTTLE)
50090-4671-04 Ondansetron, A-S Medication Solutions: 48 billing units per package (6 TABLET, FILM COATED in 1 BOTTLE)
62135-0350-05 Ondansetron, Chartwell: 2000 billing units per package (500 TABLET in 1 BOTTLE)
16714-0671-02 Ondansetron, Northstar RxLLC: 40 billing units per package (1 BOTTLE, PLASTIC in 1 CARTON / 50 mL in 1 BOTTLE, PLASTIC)
68788-8365-05 Ondansetron, Preferred Pharmaceuticals Inc: 40 billing units per package
68788-8582-01 Ondansetron, Preferred Pharmaceuticals Inc: 80 billing units per package (10 TABLET, FILM COATED in 1 BOTTLE)
68788-8651-02 Ondansetron, Preferred Pharmaceuticals Inc: 48 billing units per package (12 TABLET, FILM COATED in 1 BOTTLE)
68788-9368-03 Ondansetron, Preferred Pharmaceuticals Inc: 120 billing units per package (30 TABLET, FILM COATED in 1 BOTTLE)
68788-9402-03 Ondansetron, Preferred Pharmaceuticals Inc: 240 billing units per package (30 TABLET, FILM COATED in 1 BOTTLE)
50090-3178-00 Ondansetron HCl, A-S Medication Solutions: 40 billing units per package (10 TABLET, FILM COATED in 1 BOTTLE)
50090-3178-01 Ondansetron HCl, A-S Medication Solutions: 24 billing units per package (6 TABLET, FILM COATED in 1 BOTTLE, PLASTIC)
50090-3178-02 Ondansetron HCl, A-S Medication Solutions: 80 billing units per package (20 TABLET, FILM COATED in 1 BOTTLE, PLASTIC)
50090-3178-04 Ondansetron HCl, A-S Medication Solutions: 12 billing units per package (3 TABLET, FILM COATED in 1 BOTTLE, PLASTIC)
50090-3178-05 Ondansetron HCl, A-S Medication Solutions: 48 billing units per package (12 TABLET, FILM COATED in 1 BOTTLE, PLASTIC)
50090-3185-00 Ondansetron HCl, A-S Medication Solutions: 32 billing units per package (4 TABLET, FILM COATED in 1 BOTTLE)
50090-6342-00 Ondansetron HCl, A-S Medication Solutions: 40 billing units per package (10 TABLET, FILM COATED in 1 BOTTLE)
50090-6342-01 Ondansetron HCl, A-S Medication Solutions: 24 billing units per package (6 TABLET, FILM COATED in 1 BOTTLE)
50090-6342-02 Ondansetron HCl, A-S Medication Solutions: 80 billing units per package (20 TABLET, FILM COATED in 1 BOTTLE)
50090-6342-05 Ondansetron HCl, A-S Medication Solutions: 48 billing units per package (12 TABLET, FILM COATED in 1 BOTTLE)
60687-0252-86 Ondansetron HCl, American Health Packaging: 120 billing units per package (3 TRAY in 1 CASE / 10 CUP, UNIT-DOSE in 1 TRAY / 5 mL in 1 CUP, UNIT-DOSE)
68084-0220-01 Ondansetron HCl, American Health Packaging: 400 billing units per package (100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 TABLET, FILM COATED in 1 BLISTER PACK)
68084-0221-01 Ondansetron HCl, American Health Packaging: 800 billing units per package (100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 TABLET, FILM COATED in 1 BLISTER PACK)
50268-0621-15 Ondansetron HCl, AvPAK: 200 billing units per package (50 BLISTER PACK in 1 BOX / 1 TABLET, FILM COATED in 1 BLISTER PACK)
50268-0622-15 Ondansetron HCl, AvPAK: 400 billing units per package (50 BLISTER PACK in 1 BOX / 1 TABLET, FILM COATED in 1 BLISTER PACK)
50268-0647-14 Ondansetron HCl, AvPAK: 160 billing units per package (40 CUP, UNIT-DOSE in 1 TRAY / 5 mL in 1 CUP, UNIT-DOSE)
62135-0350-30 Ondansetron HCl, Chartwell: 120 billing units per package (30 TABLET in 1 BOTTLE)
62135-0351-05 Ondansetron HCl, Chartwell: 4000 billing units per package (500 TABLET in 1 BOTTLE)
62135-0351-30 Ondansetron HCl, Chartwell: 240 billing units per package (30 TABLET in 1 BOTTLE)
62135-0555-24 Ondansetron HCl, Chartwell: 80 billing units per package (2 TRAY in 1 BOX / 10 PACKAGE in 1 TRAY / 5 mL in 1 PACKAGE)

And 74 more NDCs.

Physician Fee Schedule (CY 2026, RVU26D)

Status E: excluded from the PFS by regulation.

Payer policies and prior authorization for Q0162

Payer coverage policies that name Q0162

Q0162 appears in 6 coverage policies from Aetna, UnitedHealthcare.

Payer	Policy	Role in policy	Reviewed	Document
Aetna	Antiemetic Therapy (0724)	listed, no stance	Jul 17, 2026	payer document
Aetna	Gastric Pacing / Electrical Stimulation and Gastroesophageal Per Oral Endoscopic Myotomy (0678)	listed, no stance	Oct 7, 2025	payer document
Aetna	Myalgic Encephalomyelitis - Chronic Fatigue Syndrome (ME/CSF) (0369) Anakinra, nutraceutical interventions, probiotics, Intravenous glutathione	not covered	May 20, 2026	payer document
UnitedHealthcare	Antiemetics for Oncology (CS2026D0093O)	listed, no stance	Apr 1, 2026	payer document
UnitedHealthcare	Medicare Part B Step Therapy Programs (IAP.001.30) Preferred	listed, no stance	Jul 1, 2026	payer document
UnitedHealthcare	Oncology Medication Clinical Coverage (2026D0030AR)	listed, no stance	Sep 1, 2026	payer document

Medicaid fee-for-service

AZ: $0.02 (outpatient_hospital), effective Apr 1, 2026
IN: $0.02 (professional, Advanced Practice Nurse (85%), non-facility), effective Apr 1, 2021
KY: $0.00 (asc), effective Jan 1, 2026
MA: $0.01 (dme_rates), effective Mar 1, 2026
ND: $0.02 (physician), effective Aug 1, 2026
NE: $0.01 (injectables), effective Jul 1, 2026
OK: $0.02 (physician, non-facility), effective Jul 1, 2026
VA: $0.01 (medical), effective Oct 1, 2023
VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
WA: $0.02 (professional_administered_drugs), effective Jul 1, 2026
WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), effective Apr 1, 2026

From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.

Q0162 Ondansetron oral