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:
- M0239: Intravenous infusion, bamlanivimab-xxxx, includes infusion and post administration monitoring
- Q0239: Injection, bamlanivimab-xxxx, 700 mg
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:
- Q0245 injection, bamlanivimab and etesevimab, 2100 mg
- M0245 intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring
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.