Cutaquig (SCIG 16.5%) — HCPCS J1551
CareCost Estimate · Billing Cheat Sheet
Octapharma USA
16.5% (165 mg/mL) — only non-20% SCIG · 1g, 2g, 4g, 8g vials
Subcutaneous pump (NOT IV)
Reviewed: May 2, 2026
ASP: Q2 2026
HCPCS
J1551
1 unit = 100 mg (NOT 500)
PI Weekly (10g)
100 units
100 mg/kg/wk x ~70 kg
Modifier
JZ
Single-dose vial
Admin CPT
96369+96370+96371
SCIG pump (not 96365)
Medicare ASP+6%
$13.927
/100 mg · lowest SCIG
BILLER TRAPS: (1) J1551 = 100 mg per unit (different from IVIG codes which use 500 mg). (2) SCIG admin codes are 96369/96370/96371 (pump infusion) — NOT 96365/96366 (IV) and NOT 96372 (SC injection). (3) Cutaquig is 16.5% NOT 20% — larger volume, more sites, longer sessions → bill 96370/96371 more frequently.
POSITIONING: Cutaquig is the lowest-cost SCIG by Medicare ASP+6% (Q2 2026: $13.927 vs Hizentra $14.515, Xembify ~$15, Cuvitru ~$17). Cost-conscious payer policies and 340B economics increasingly favor Cutaquig within the SCIG class.
Codes & vials
| HCPCS | J1551 — "Inj cutaquig 100 mg" (1 unit = 100 mg) |
|---|
| Concentration | 16.5% liquid (165 mg/mL) — ONLY non-20% major SCIG |
|---|
| Vial sizes | 1 g/6 mL, 2 g/12 mL, 4 g/24 mL, 8 g/48 mL (single-dose) |
|---|
| Stabilizer | Maltose — CI in fructose intolerance; caution non-glucose-specific meters |
|---|
| Storage | Refrigerate 2–8°C; room temp window per current label |
|---|
| Indication | Primary humoral immunodeficiency (PI), adults + ped ≥2 yr only — NO CIDP |
|---|
SCIG admin codes (CRITICAL)
| Code | When |
|---|
96369 | SC infusion via mechanical pump, initial up to 1 hr |
96370 | Each addl hr (frequently billed at 16.5% volumes) |
96371 | Addl pump set-up (e.g., 2nd site, 2nd pump) |
NOT 96372 (manual SC injection). NOT 96365/96366 (IV). At 16.5% Cutaquig, larger volumes drive longer sessions / multiple sites — 96370 + 96371 commonly billed alongside 96369.
Indication-specific dosing
| Scenario | Dose | Schedule |
|---|
| PI conversion from IVIG | 1.37 × IVIG monthly ÷ 4 | Weekly |
| PI maintenance | 100–200 mg/kg/wk | Weekly typical |
| Frequency options | weekly / biweekly / more frequent than weekly | Patient preference per label |
CIDP NOT FDA-approved for Cutaquig. Use Hizentra (J1559) or HyQvia (J1575) for SCIG CIDP maintenance.
16.5% vs 20% concentration
| Factor | Cutaquig 16.5% | 20% SCIGs |
|---|
| 10 g volume | ~60.6 mL | ~50 mL |
| Volume premium | +21% | baseline |
| Sites/session | 2–4 typical | 1–2 typical |
| Session length | 90–180 min | 60–120 min |
| Tissue distension | Gentler (lower viscosity) | More aggressive |
Switch from 20% → Cutaquig 16.5% = documented strategy for persistent local site reactions on Hizentra/Cuvitru/Xembify.
SCIG brand interchangeability
| Brand | HCPCS | Conc. | Stab. | $/unit |
|---|
| Cutaquig | J1551 | 16.5% | Maltose | $13.93 |
| Hizentra | J1559 | 20% | Proline | $14.52 |
| Xembify | J1558 | 20% | Glycine | ~$15 |
| Cuvitru | J1555 | 20% | Glycine | ~$17 |
| HyQvia (IG+hyal.) | J1575 | 10% | Glycine | varies |
| Gamunex-C SC | J1561 | 10% | Glycine | 500 mg/u |
Cutaquig is the only non-20% SCIG. Cutaquig + Octagam (J1568 IVIG) are both Octapharma maltose products.
ICD-10 (PI only)
| Code | For |
|---|
D80.x | PI — antibody defects (D80.0 XLA, D80.1 hypogamma, D80.3 IgG subclass) |
D81.x | PI — combined immunodeficiencies |
D82.x | PI — other major defects (Wiskott-Aldrich, DiGeorge) |
D83.x | CVID family |
G61.81 | NO — Cutaquig has no CIDP indication. Use Hizentra (J1559) or HyQvia (J1575). |
Home self-administration (the norm)
- Patient training: typically 1–3 in-clinic sessions with infusion nurse
- Multiple SC sites per session (abdomen, thighs, hip) — especially at 16.5% volumes
- 90–180 min per session via mechanical pump (Freedom60, CRONO-S, etc.)
- Major billing impact: home health vs office (POS 12 most common after training)
- Some plans: medical benefit (J1551 + 96369-96371 + S9338 per-diem); others: pharmacy/specialty
Payer requirements (May 2026)
| Payer | PA | Requirements / Cutaquig position |
|---|
| UnitedHealthcare | Yes | PI dx + IgG levels + vaccine challenge + training docs; cost-of-care steering may favor lowest-cost SCIG (Cutaquig) |
| Aetna | Yes | Same; clinician choice across SCIG class generally allowed |
| Cigna | Yes | Home infusion vendor; SCIG/IVIG parity |
| Medicare LCD | Yes | FDA-approved indication (PI); home-infusion benefit per Cures Act framework |
Medicare reimbursement (Q2 2026)
| Field | Value |
|---|
| ASP + 6% | $13.927 / 100 mg unit = $139.27/g |
| 7 g weekly (70 kg, 100 mg/kg) | $974.89 |
| 10 g weekly (PI maint.) | $1,392.70 |
| Annual (10 g/wk × 52) | ~$72,420 |
| vs Hizentra (10 g/wk annual) | ~$75,478 — ~$3,000/yr cheaper |
| vs Cuvitru (10 g/wk annual) | ~$91,520 — ~$19,000/yr cheaper |
Patient assistance — Octapharma OneSource
- Phone: 1-888-429-4535 (Octapharma OneSource — covers Cutaquig + Octagam)
- Cutaquig Co-Pay Assistance Program (commercial)
- Octapharma Patient Assistance for uninsured / Medicare income-tested
- Foundations for Medicare: PAN, HealthWell, PAF (verify open PI funds quarterly)
- Web: cutaquig.com · octapharma.com
Pending SME review. Verify against current Octapharma label, UHC SCIG LCD, and CMS ASP file at billing time.