On April 16, the FDA revoked the emergency use authorization (EUA) that allowed for the investigational monoclonal antibody therapy bamlanivimab, when administered alone, to be used to treat mild-to-moderate COVID-19 in adults and certain pediatric patients.
With the FDA revocation, these codes are no longer covered:
We have updated our temporary COVID-19 payment policy to reflect this change. In March we added the following two new HCPCS codes to the temporary COVID-19 payment policy for monoclonal antibody treatment for COVID-19 infections. These codes continue to be covered:
Please note that bamlanivimab, administered in combination with etesevimab, continues to have FDA EUA for the treatment of mild to moderate COVID-19 in adults and pediatric patients (12 years of age and older weighing at least 40 kg) with positive results of direct SARS-CoV-2 viral testing. The treatment is for those at high risk for progressing to severe COVID-19 or hospitalization.