Q0164 Insurance Policy Changes

HCPCS Q0164 is officially defined as "Prochlorperazine maleate, 5 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." HCPCS Q0164 is referenced in 1 tracked payer policy change from Aetna. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS Q0164 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

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All billing codesJ3590C9399J3490992139921499212

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