Are there new HCPCS codes for the COVID-19 monoclonal antibody treatment bebtelovimab?

Yes.  On February 11, 2022, the FDA authorized emergency use of bebtelovimab for treatment of mild-to-moderate COVID-19 in certain adult and pediatric patients who are at high risk for progression to severe COVID-19, including hospitalization or death, when:

  • The patient has a positive COVID-19 test result; and
  • Alternative COVID-19 treatment options are not available or are not clinically appropriate.

It is important to note that the EUA does not authorize bebtelovimab for use in adult or pediatric patients who are already hospitalized due to COVID-19.

Three new codes were created and have an effective date of February 11, 2022, which coincides with the FDA date of EUA.  Long descriptors for the new codes are as follows:

For the product:

  • Q0222  Injection, bebtelovimab, 175 mg

Administration codes:

  • 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

Resources:

CMS MLN Connects, dated 2/18/2022
https://www.cms.gov/outreach-and-educationoutreachffsprovpartprogprovider-partnership-email-archive/2022-02-18-mlnc-se

FDA Emergency Use Authorization
https://www.fda.gov/media/156151/download

COVID-19 Monoclonal Antibodies
https://www.cms.gov/monoclonal