Summary & Overview
HCPCS C9466: Injection, Benralizumab, 1 mg
HCPCS Level II code C9466 denotes the drug product unit for benralizumab, billed as an injection per 1 mg. Benralizumab is a monoclonal antibody used in respiratory and immunologic care; clear drug-level billing units like C9466 matter nationally because they standardize how payers reimburse high-cost biologics, affect site-of-care economics, and influence patient access. Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise overview of what C9466 represents clinically and operationally, how major payers approach coverage and reimbursement for injectable biologics, and the implications for outpatient infusion and physician office administration. The publication summarizes benchmark pricing and payment patterns, notes relevant coding relationships, and highlights policy updates that commonly affect biologic drug billing (for example, payment per milligram versus per vial). Clinical context explains the service type and typical sites of service where benralizumab is administered. Where input data were not provided, the report indicates that those specific data elements are not available in the input.
Billing Code Overview
HCPCS Level II code C9466 represents injection, benralizumab, 1 mg. This billing code describes a measured parenteral administration unit of the monoclonal antibody benralizumab, typically supplied and billed per milligram.
Service type: Injectable biologic medication administration (drug billing unit)
Typical site of service: Outpatient infusion/clinic setting or physician office
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with severe eosinophilic asthma or eosinophilic chronic rhinosinusitis who requires maintenance therapy with benralizumab. The patient presents to an outpatient infusion or injection clinic affiliated with a pulmonology or allergy-immunology practice. After a clinician documents persistent symptoms or exacerbations despite high-dose inhaled corticosteroids and additional controller therapy, the decision is made to initiate or continue subcutaneous benralizumab therapy.
The clinical workflow includes: initial evaluation and documentation of indication and prior therapies; baseline assessment including spirometry and eosinophil count review; patient consent and medication reconciliation; preparation of the correct benralizumab dose (billed as C9466 per mg); administration of the subcutaneous injection by a registered nurse or licensed practical nurse; monitoring for immediate adverse reactions for 15–30 minutes post-injection; documentation of lot number, injection site, and patient tolerance in the medical record; and scheduling of subsequent dosing visits. Typical dosing visits occur in an outpatient clinic, specialty infusion center, or physician office setting using the HCPCS Level II code C9466 to report benralizumab by the milligram when applicable for billing and inventory tracking.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 |