Updated on 07/22/2021

COVID-19: EUA for Tocilizumab Monoclonal Antibody Product

On June 24, 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: $450.00 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: $450.00 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.

Article published by CMS on July 23, 2021
CLICK HERE to read original post