M0224 HCPCS - INTRAVENOUS INFUSION, 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, WHO EITHER HAVE MODERATE-TO-SEVERE IMMUNE COMPROMISE DUE TO A MEDICAL CONDITION OR RECEIPT OF IMMUNOSUPPRESSIVE MEDICATIONS OR TREATMENTS, INCLUDES INFUSION AND POST ADMINISTRATION MONITORING

Code Information

HCPCS Code: M0224
Sequence Number: 0010
Short Description: Pemivibart infusion
Long Description: Intravenous infusion, 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, who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive medications or treatments, includes infusion and post administration monitoring
Date Added: 3/22/2024
Action Code: A - Add procedure or modifier code
Action Effective Date: 3/22/2024
Classification: Medical Services
Coding System: HCPCS

Berenson-Eggers Type Of Service Code: O1G - Immunizations/Vaccinations
Type Of Service Code:
- V - Pneumococcal/flu vaccine (eff 01/96), Pneumococcal/flu/hepatitis B vaccine (eff 04/95-12/95), Pneumococcal only before 04/95

Pricing Indicator Code:
- 54 - Vaccinations
Multiple Pricing Indicator Code: A - Not applicable as HCPCS priced under one methodology
Coverage Issues Manual Reference Section Number:
N/A
Medicare Carriers Manual Reference Section Number:
N/A
Coverage Code: C - Carrier judgment

Field Name	Field Value
Healthcare Common Procedure Coding System Code	M0224
HCPCS Sequence Number	0010
HCPCS Record Identification Code	3 - First line of procedure record also contains detail information in positions 92-275
HCPCS Long Description	Intravenous infusion, 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, who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive medications or treatments, includes infusion and post administration monitoring
HCPCS Short Description	Pemivibart infusion
HCPCS Pricing Indicator Code 1	54 - Vaccinations
HCPCS Multiple Pricing Indicator Code	A - Not applicable as HCPCS priced under one methodology
HCPCS Coverage Code	C - Carrier judgment
HCPCS Berenson-Eggers Type Of Service Code	O1G - Immunizations/Vaccinations
HCPCS Type Of Service Code 1	V - Pneumococcal/flu vaccine (eff 01/96), Pneumococcal/flu/hepatitis B vaccine (eff 04/95-12/95), Pneumococcal only before 04/95
HCPCS Anesthesia Base Unit Quantity	0
HCPCS Code Added Date	3/22/2024
HCPCS Action Effective Date	3/22/2024
HCPCS Action Code	A - Add procedure or modifier code