Cinqair (reslizumab) — HCPCS J2786
CareCost Estimate · Billing Cheat Sheet
Teva Pharmaceuticals
100 mg/10 mL single-dose vial (10 mg/mL)
IV (only IV anti-IL-5) ~30-50 min
Reviewed: May 3, 2026
ASP: Q2 2026
Std Dose
3 mg/kg
IV q4wk · weight-based
Modifier
JZ + JW
Weight-based dosing → waste
Admin CPT
96365
Therapeutic IV, non-chemo
Medicare ASP+6%
$11.532
/mg · ~$2,422 / 70 kg pt
Codes & NDC
| HCPCS | J2786 — "Injection, reslizumab, 1 mg" |
|---|
| NDC | 59676-955-01 100 mg/10 mL single-dose vial |
|---|
| Concentration | 10 mg/mL (dilute in 50 mL 0.9% NaCl for IV) |
|---|
| Storage | Refrigerate 2-8°C |
|---|
| Class | Anti-IL-5 (binds soluble IL-5) |
|---|
Dosing & unit math (3 mg/kg q4wk)
| Weight | Dose | Units | Vials | JW waste |
|---|
| 50 kg | 150 mg | 150 | 2 × 100 mg | 50 |
| 70 kg | 210 mg | 210 | 3 × 100 mg | 90 |
| 90 kg | 270 mg | 270 | 3 × 100 mg | 30 |
| 100 kg | 300 mg | 300 | 3 × 100 mg | 0 |
Eosinophil biomarker
- Required: blood eos ≥400 cells/µL (significantly higher than Nucala ≥150)
- Document baseline eos count in chart
- Adults only (≥18 yr) — no pediatric indication
Tightest eos threshold in anti-IL-5 class. Patients failing Cinqair LCD may qualify for Nucala (≥150) or Fasenra (no FDA threshold).
Admin & modifiers
| Code | When |
|---|
96365 | Therapeutic IV, non-chemo (primary, 30-50 min infusion) |
| NOT 96372 (that's SC), NOT 96413/96415 (chemo) |
BOXED WARNING — Anaphylaxis (~0.3% incidence). Healthcare professional admin REQUIRED. ≥30 min observation post-infusion. NOT for self-administration.
ICD-10 — severe eos asthma
| Code | For |
|---|
J45.40 | Mod persistent uncomplicated |
J45.41 | Mod persistent w/ exacerbation |
J45.42 | Mod persistent w/ status |
J45.50 | Severe persistent uncomplicated |
J45.51 | Severe persistent w/ exacerbation |
J45.52 | Severe persistent w/ status |
Anti-IL-5 class comparison
| Drug | Route | Dose | Eos | Boxed |
|---|
| Cinqair | IV q4wk | 3 mg/kg | ≥400 | Yes |
| Nucala | SC q4wk | 100 mg fixed | ≥150 | No |
| Fasenra | SC q4wk → q8wk | 30 mg fixed | None FDA | No |
Payer requirements (May 2026)
| Payer | PA | Requirements |
|---|
| UnitedHealthcare | Yes | Eos ≥400 + ICS/LABA failure + pulm consult |
| Aetna | Yes | May step from SC anti-IL-5 first |
| Cigna | Yes | IV admin in office/clinic only |
| Medicare LCD | Yes | FDA-approved adult asthma indication |
Medicare reimbursement (Q2 2026)
| Field | Value |
|---|
| ASP + 6% | $11.532 / mg (eff. 4/1 - 6/30/2026) |
| 70 kg dose (210 mg) | $2,421.72 |
| 90 kg dose (270 mg) | $3,113.64 |
| Annual (13 doses, 70 kg) | ~$31,482 |
Site of care
| Setting | POS | Notes |
|---|
| Physician office | 11 | Most common |
| Ambulatory infusion suite | 49 | Common (anaphylaxis precautions) |
| Hospital outpatient | 19/22 | UHC/Aetna disfavor |
| Patient home | — | NOT permitted (Boxed) |
Patient assistance — Teva
- Phone: 1-888-825-1356 (Teva Shared Solutions)
- Cinqair Patient Support — commercial copay assistance
- Free drug for uninsured (income-tested)
Pending SME review. Verify against current Teva label, payer policies, and CMS ASP file at billing time.