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COVID-19 Antibody Therapy Administration

Please see the table below for the appropriate procedure codes to be used when billing Health Partners Plans (HPP) for COVID-19 antibody therapy administration to HPP members and the reimbursements applicable to those codes. HPP will follow both the Centers for Medicaid & Medicare Services (CMS) and the Pennsylvania Department of Human Services (DHS) policies related to coding and reimbursement.

It is important to note that the coding and reimbursement detailed in this communication are applicable to all provider types and the outpatient place of service.

Monoclonal Antibody Therapy Code Administration Code Medicaid Medicare Par and Non-Par CHIP Non-Par Providers Medicaid & CHIP

M0239

Eli Lilly and Company

intravenous infusion, bamlanivimabxxxx,
includes infusion and post
administration monitoring

$247.68 $0

Provider is required to bill CMS

$247.68 $247.68

M0243

Regeneron

intravenous infusion, casirivimab and
imdevimab includes infusion and post-administration monitoring

$247.68

$0
Provider is required to bill CMS

$247.68 $247.68

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