January 4, 2021
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, |
$247.68 | $0
Provider is required to bill CMS |
$247.68 | $247.68 |
|
M0243 Regeneron intravenous infusion, casirivimab and |
$247.68 |
$0 |
$247.68 | $247.68 |
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