Important Updates Regarding Coronavirus COVID-19: CMS Announces Medicare and Medicaid Coverage of COVID-19 Antibody Treatment
11/16/2020
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Posted by Provider Relations
Please see new information added to our updates regarding COVID-19. The details surrounding the CMS Antibody Treatment program can be found in the Coding section of our Important Updates Regarding Coronavirus COVID-19 resource article and is also referenced below:
The Centers for Medicare & Medicaid Services announced that starting November 10th 2020, Medicare beneficiaries can receive coverage of monoclonal antibodies to treat coronavirus disease 2019 (COVID-19) with no cost-sharing during the public health emergency (PHE). CMS’ coverage of monoclonal antibody infusions applies to bamlanivimab, which received an emergency use authorization (EUA) from the U.S. Food and Drug Administration in November. In their fact sheet linked below, CMS states that providers who participate in a Medicare Advantage Plan should submit claims for bamlanivimab administration to Original Medicare for all patients enrolled in Medicare Advantage in 2020 and 2021. CMS also expects Medicaid programs to cover the antibody treatment for Medicaid beneficiaries with limited exceptions.
CMS will issue billing and coding instructions for health care providers in the coming days. To view the Monoclonal Antibody COVID-19 Infusion Program Instruction, visit: https://www.cms.gov/files/document/covid-medicare-monoclonal-antibody-infusion-program-instruction.pdf
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Q0239
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Injection, bamlanivimab-xxxx, 700 mg
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M0239:
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Intravenous infusion, bamlanivimab-xxxx, includes infusion and post administration monitoring
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