New COVID-19 treatment codes to take effect in July

In the latest update to its Vaccine Administration National Fee Schedule, CMS established three Level II Healthcare Common Procedure Coding System (HCPCS) codes to bill for TOFIDENCE®, a biosimilar to ACTEMRA®, when used to treat COVID-19.

TOFIDENCE was approved by the FDA in July 2024 for intravenous administration in hospitalized adults with COVID-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation.

Effective July 1, organizations can use HCPCS code Q0234 to bill for the product, as well as HCPCS codes M0231 (first dose) and M0232 (second dose) to bill for the administration.

CMS noted that facilities could bill by reporting the not otherwise classified (NOC) COVID-19 monoclonal antibody HCPCS product code (Q0235) and associated administrative codes (M0235 and M0236). Introduced in October 2025, these NOC codes are used to bill FDA-approved products not yet assigned to a unique HCPCS Level II code. Facilities should use the most specific code when one is available.

Revenue integrity professionals can view Medicare Claims Processing Transmittal 13733 for more information.