2022 Comprehensive Covid-19 Guide (continued) Code CPT Long Descriptor Injection, tixagevimab and cilgavimab, for the pre-exposure prophylaxis only, for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) with no known sars-cov-2 exposure, who either have moderate to severely compromised immune systems or for whom vaccination with any available covid-19 vaccine is not M0221 recommended due to a history of severe adverse reaction to a covid-19 vaccine(s) and/or covid-19 vaccine component(s), 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
Payment Allow after 05/06/2021
Effective Date
$250.50
12/08/2020
The FDA provides a provider Fact Sheet for the EAU through their website: https://www.fda.gov/media/154701/download?utm_medium=email&utm_source=govdelivery
RHCs and FQHCs COVID-19 Monoclonal Antibody Therapy Billing RHCs and FQHCs cannot bill COVID-19 for monoclonal administration on a claim form. If the patient is there for another reason, the RHC or FQHC should exclude the cost of the monoclonal antibodies. It will be settled on a cost report. A listing of payment rates by each type of Medicare provider can be found in the Medicare FAQ link.
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