CMS releases new HCPCS code for EVUSHELD™

The FDA revised its emergency use authorization for EVUSHELD™, tixagevimab co-packaged with cilgavimab. The initial dose authorized has been changed to 600 mg for pre-exposure prevention of COVID-19.

In response, CMS created a new Healthcare Common Procedure Coding System (HCPCS) code, Q0221, which took effect on February 24. The descriptors are as follows:

• Long descriptor: Injection, tixagevimab and cilgavimab, for the pre-exposure prophylaxis only, for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) with no known sars-cov-2 exposure, who either have moderate to severely compromised immune systems or for whom vaccination with any available covid-19 vaccine is not recommended due to a history of severe adverse reaction to a covid-19 vaccine(s) and/or covid-19 vaccine component(s), 600 mg
• Short descriptor: Tixagev and cilgav, 600mg

The existing administration codes, M0220 and M0221, should be used for tixagevimab and cilgavimab. More information on dosage and administration can be found in the FDA’s fact sheet.

Editor’s note: Access more NAHRI resources on COVID-19 coding and billing here.