HCPCS Code Q0224

Official Description

Injection, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known SARS-CoV-2 exposure, and who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive medications or treatments, and are unlikely to mount an adequate immune response to COVID-19 vaccination, 4500 mg

Short Descr	Inj, pemivibart, 4500 mg
Related Drugs	pemgarda
Coverage	Carrier Priced
Pricing Indicator(s)	54 – Vaccinations
MPI	A – Not applicable, as HCPCS priced under one methodology
BETOS	O1G – Immunizations/Vaccinations
TOS Code(s)	V – Pneumococcal/flu vaccine
Added Date	3/22/2024
Status Code	Statutory Exclusion (from MPFS, may be paid under other methodologies)
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	9 - Not Applicable
Multiple Procedures (51)	9 - Concept does not apply.
Bilateral Surgery (50)	9 - Concept does not apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	9 - Concept does not apply.
Co-Surgeons (62)	9 - Concept does not apply.
Team Surgery (66)	9 - Concept does not apply.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	Influenza, Pneumococcal Pneumonia, Hepatitis B, and Covid-19 Vaccines; Monoclonal Antibody Therapy Product
ASC Payment Indicator	Influenza vaccine; pneumococcal vaccine.
MUE	1
MUE	Not applicable/unspecified.
OTS Orthotic	No