COVID-19 Monoclonal Antibody: New Codes for PEMGARDA

COVID-19; Reimbursement

On March 22, 2024, the Food and Drug Administration (FDA) released an emergency use authorization for the PEMGARDA (pemivibart) investigational monoclonal antibody product for pre-exposure prophylaxis of COVID-19 in certain adults and adolescents.  

Providers must now use two new HCPCS codes, effective March 22, 2024: 

  1. Product code Q0224  
  2. Administration code M0224 

Providers can visit COVID-19 Monoclonal Antibodies for more information and get the most current list of billing codes, including short descriptors, payment allowances, and effective and termination dates. Users may need to refresh their web browser if they recently visited the webpage. 

Note: These products are subject to Medicare SNF Consolidated billing​