COVID-19: EUA for Tocilizumab Monoclonal Antibody Product
July 23, 2021
Policy Snapshot
Last month, the FDA released an Emergency Use Authorization (EUA) for tocilizumab, a COVID-19 monoclonal antibody product. CMS created new HCPCS codes, effective June 24, for tocilizumab and to administer it in the inpatient setting.
Q0249:
- Long Descriptor: Injection, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with COVID-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ECMO) only, 1 mg
- Short Descriptor: Tocilizumab for COVID-19
- Price: The government won’t provide this drug for free; visit the COVID-19 Vaccines and Monoclonal Antibodies webpage for pricing information (available soon)
M0249:
- Long Descriptor: Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with COVID-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ECMO) only; includes infusion and post-administration monitoring, first dose
- Short Descriptor: Adm tocilizu covid-19 1st
- Price: $450 per infusion
M0250:
- Long Descriptor: Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with COVID-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ECMO) only; includes infusion and post-administration monitoring, second dose
- Short Descriptor: Adm tocilizu covid-19 2nd
- Price: $450 per infusion
Billing Note: You can’t use the Roster Bill form to report multiple units or infusions. Submit individual claims for the tocilizumab product and infusions when reporting multiple units of the product and/or the first and second infusions.
More Information: