CMS creates codes for newly authorized monoclonal antibody injections

The Centers for Medicare & Medicaid Services (CMS) has created codes for administering bebtelovimab, a monoclonal antibody injection recently authorized for treating mild-to-moderate COVID-19 in some patients. The codes, effective Feb. 11, are:

• Q0222: Injection, bebtelovimab, 175 mg.
• M0222: Intravenous injection, bebtelovimab, includes injection and post administration monitoring.
• M0223: Intravenous injection, bebtelovimab, includes injection and post administration monitoring in the home or residence; this includes a beneficiary’s home that has been made provider-based to the hospital during the COVID-19 public health emergency.

For more information, visit the CMS COVID-19 Monoclonal Antibodies webpage.

The Food and Drug Administration (FDA) authorized the emergency use of bebtelovimab for patients 12 and over. The treatment is authorized when all of these conditions apply:

• The patient has a positive COVID-19 test.
• The patient is at high-risk for progressing to severe COVID-19.
• Alternative COVID-19 treatment options approved or authorized by the FDA aren’t accessible or clinically appropriate for the patient.

Bebtelovimab was observed to be effective against both the omicron variant and the BA.2 omicron subvariant.

— Kent Moore, senior strategist for physician payment, American Academy of Family Physicians

Posted on Feb. 21, 2022, by Kent Moore