HCPCS Q0224
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
HCPCS Information
- HCPCS Code: Q0224
- The Healthcare Common Procedure Coding System (HCPCS) is a set of unique alphanumeric codes used to report medical procedures and services to healthcare programs like Medicare and Medicaid. HCPCS codes are used in conjunction with NDC codes for billing and medical documentation puporses. For instance, HCPCS Q0224 identifies the type of service or supply used while any of the 1 NDC codes below could be used to specify the exact drug used.
- Short Description
- Inj, pemivibart, 4500 mg
- Long 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
- Pricing Indicator
- Vaccinations
- Multiple Pricing Indicator
- Not applicable as HCPCS priced under one methodology
- Coverage Description
- Carrier judgment
- BETOS Type of Service
- Immunizations/Vaccinations
- Medicare Payment Limit
- $7,239.00
- Medicare Co-Insurance Percentage
- 0.000%
- Medicare Pricing Notes
- See COVID-19 vaccine pricing webpage for payment effective dates
- HCPCS Classification
- List of HCPCS codes for: Temporary Codes (Q-codes)
HCPCS Crossover to NDC Codes
The NDC codes below allow precise billing based on the specific manufacturer and medication used:
| NDC | Proprietary Name | Non-Proprietary Name | Dosage Form | Route Name | Company Name | Status | |
|---|---|---|---|---|---|---|---|
| 81960-031 | Pemgarda | Pemivibart | Injection | Intravenous | Invivyd, Inc | ACTIVE |
