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Independence Blue CrossCommercial · Billing Codes · Pharmacy · PA · Rheumatology, Gastroenterology, Dermatology +3 moreHigh impact

08.00.34x, Intravenous Infliximab and Related Biosimilars

Act
by Dec 15, 2025
Effective date
Jan 1, 2026
Identified
Jun 19, 2026

Summary

Independence Blue Cross removed HCPCS code Q5109 (Injection, infliximab-qbtx, biosimilar, ixifi, 10 mg) from the Intravenous Infliximab and Related Biosimilars policy effective January 1, 2026. Billing teams must stop using this code for ixifi biosimilar claims and switch to alternative approved infliximab codes to avoid claim denials.

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What to do

by Dec 15, 2025 · 6 steps
01Billing team must update billing system to REJECT or BLOCK HCPCS code Q5109 (infliximab-qbtx/ixifi) for all Independence Blue Cross commercial claims effective 01/01/2026.
02Do NOT bill Q5109 on or after this date.
03For claims requiring ixifi biosimilar reimbursement, use only the remaining approved codes: J1745 (unbranded infliximab), Q5103 (inflectra), Q5104 (renflexis), or Q5121 (avsola).
04Verify with providers and prior authorization departments which alternative code applies to each patient's current therapy.
05Any claims submitted with Q5109 on or after 01/01/2026 will be denied by Independence Blue Cross.
06Communicate this change to all clinical staff and update charge capture systems.

Codes mentioned

Q5109J1745Q5103Q5104Q5121

Original notice

08.00.34x, Intravenous Infliximab and Related Biosimilars
medpolicy.ibx.com · Always check the source before changing claims.
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Related changes

See all Independence Blue Cross changes →
MA08.019q, Intravenous Infliximab and Related BiosimilarsMediumEffective Jan 1, 2026 · PharmacyMA08.019o, Intravenous Infliximab and Related BiosimilarsMediumEffective Apr 21, 2025 · PharmacyMA08.019p, Intravenous Infliximab and Related BiosimilarsMediumEffective Oct 1, 2025 · Pharmacy08.00.34v, Intravenous Infliximab and Related BiosimilarsMediumEffective Apr 21, 2025 · PharmacyBrowse every Independence Blue Cross change in the policy list

Related policy hubs

Independence Blue Cross policiesPA policy changesRheumatologyGastroenterologyDermatologyOncologyOphthalmologyPharmacyCode Q5109Code J1745Code Q5103Code Q5104Code Q5121

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