Payment Allowance Update for COVID-19 Monoclonal Antibody Therapy Q0222 Injection, Bebtelovimab, 175 mg
On August 15, drug manufacturer, Eli Lilly, will start commercial distribution of their COVID19 monoclonal antibody therapy, bebtelovimab, 175 mg. CMS will pay 95% average wholesale price (AWP) or $2394.00 for this product.
You might have both United States Government (USG)-purchased and commercial product in your inventory. For dates of service on or after August 15, only bill Medicare if you use commercially purchased products; don’t bill for USG-purchased products. Continue to bill for administering either type of product.
Check the Batch # on the vial. If the Batch # is D534422, the product was commercially purchased. Watch for Eli Lilly to release more information about future batch numbers.
Continue to use HCPCS codes:
- Q0222: Injection, 175 mg for the product
- M0222: Intravenous injection, includes injection and post administration monitoring
- M0223: Intravenous injection, includes injection and post administration monitoring in the home or residence; this includes a beneficiary’s home that has been made providerbased to the hospital during the covid-19 public health emergency
There’s no cost sharing (no copayment/coinsurance or deductible) through the calendar year that the COVID-19 public health emergency ends for monoclonal antibody therapies to treat COVID19 for people with Medicare.