Q5102 Inj., infliximab biosimilar

Injection, infliximab, biosimilar, 10 mg

Payer policies and prior authorization for Q5102

1 of 1 payer prior-auth lists that name Q5102 require prior authorization or set conditions: Blue Cross and Blue Shield of Texas.

PayerPlanStatePrior authConditionsSinceSource
Blue Cross and Blue Shield of TexasTexas PA exemption (gold card), outpatient, fully insuredTXprior auth requiredGold-card exemption availableJul 1, 2026BCBSTX Outpatient Prior Authorization Exemption Clinical Guidelines (max units, PA exempt date range)

Payer coverage policies that name Q5102

Q5102 appears in 1 coverage policy from Wellmark Blue Cross Blue Shield.

PayerPolicyRole in policyReviewedDocument
Wellmark Blue Cross Blue ShieldInfliximab (05.01.05)listed, no stanceApr 1, 2026payer document

Medicaid fee-for-service

  • WY: $75.52 (professional), effective Jan 1, 2018

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.