• 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

    Disclaimer: The opinions and views expressed here are those of the authors and do not necessarily represent or reflect the opinions and views of the American Academy of Family Physicians. This blog is not intended to provide medical, financial, or legal advice. Some payers may not agree with the advice given. This is not a substitute for current CPT and ICD-9 manuals and payer policies. All comments are moderated and will be removed if they violate our Terms of Use.