Summary & Overview
HCPCS Q2055: Idecabtagene Vicleucel, BCMA-Directed CAR-T Therapy
HCPCS Level II code Q2055 denotes idecabtagene vicleucel, an autologous BCMA-directed CAR-T cellular therapy including leukapheresis and dose preparation, billed per therapeutic dose (up to 510 million CAR-positive T cells). This code captures a complex, high-cost biologic therapy increasingly used in relapsed or refractory multiple myeloma and other BCMA-expressing conditions, with implications for coverage policy, site-of-care decisions, and specialty pharmacy and hospital billing workflows.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a national view of the code’s clinical scope and billing context, a summary of typical sites of service and service components, and the kinds of benchmarks and policy considerations payers and providers monitor for CAR-T therapies. The publication outlines coding composition (therapy plus leukapheresis and dose prep), common billing modifiers provided in source data, and guidance on where to find additional payer-specific coverage criteria. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code Q2055 represents idecabtagene vicleucel, a BCMA-directed autologous CAR-positive T-cell therapy dosed up to 510 million cells per therapeutic dose. The description includes leukapheresis and dose preparation procedures as part of the per-dose service.
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Service type: Cellular gene therapy administration and associated collection/preparation procedures
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Typical site of service: Hospital inpatient or hospital outpatient infusion and cell-processing facilities specializing in CAR-T therapy
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with relapsed, refractory multiple myeloma after at least three prior lines of therapy presents for autologous BCMA-directed CAR T-cell therapy with idecabtagene vicleucel (Q2055). The clinical workflow begins with hematology/oncology evaluation confirming eligibility, baseline organ function testing (CBC, CMP, viral serologies), and performance status assessment. The patient undergoes leukapheresis in an ambulatory apheresis unit or hospital outpatient infusion center to collect peripheral blood mononuclear cells, which are shipped for CAR T manufacturing. Prior to lymphodepleting chemotherapy, the patient receives pre-treatment counseling and consent, and a central venous access plan is finalized.
On return of the manufactured product, the patient is admitted or scheduled to an inpatient hematology oncology unit or specialized outpatient infusion center for product receipt, dose preparation, and infusion. Lymphodepletion (commonly fludarabine and cyclophosphamide) is administered per protocol, followed by administration of the single therapeutic dose of idecabtagene vicleucel (Q2055). Post-infusion monitoring includes inpatient observation for cytokine release syndrome and neurotoxicity with frequent vital signs, laboratory assessments, and use of tocilizumab or corticosteroids per institutional guidelines if complications occur. Follow-up visits include serial labs, infection prophylaxis management, and disease response assessment at planned intervals.
Coding Specifications
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