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The Centers for Medicare and Medicaid Services has released billing codes for Eli Lilly’s COVID-19 antibody treatment.
CMS created two billing codes for healthcare providers to receive Medicare payments from administering the antibody cocktail. The first, Q0245 is assigned to 2100 mg injections of bamlanivimab and etesevima, and the second, M0245 is to be used for intravenous infusion with post-administration monitoring.
Similar to the COVID-19 vaccine, Medicare will cover these infusions for the duration of the public health emergency.
When billing CMS for the administration of COVID-19 monoclonal antibody infusions, healthcare providers can file a single claim or by submitting a roster bill. Because the EUA’s administration guidelines are “considerably more complex” than other services, CMS expects providers to use appropriate documentation that shows the guidelines were met, as well as the name of the practitioner who ordered the infusion.
WHY THIS MATTERS
Eli Lilly’s antibody cocktail, which contains bamlanivimab and etesevimab, received emergency use authorization from the Food and Drug Administration on February 9.The EUA specifies that the antibody therapy can be used for the treatment of mild-to-moderate COVID-19 in adults and pediatric patients with positive COVID-19 test results who are at high risk for progressing to severe COVID-19 and/or hospitalization. […]