2025 HCPCS Code M0220

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), includes injection and post administration monitoring

TAGS: vaccine tixagevimab certain history vaccination weighing monitoring severely moderate injection prophylaxis compromised recommended individuals systems adverse known administration pediatric older years reaction severe immune either least available
Short DescriptionTixagev and cilgav inj
HCPCS Action Code N - No maintenance for this code
HCPCS Coverage Code C - Carrier judgment
HCPCS Code Added Date December 08, 2021
HCPCS Action Effective Date December 08, 2021
HCPCS Pricing Indicator Code 54 - Vaccinations
HCPCS 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
HCPCS Multiple Pricing Indicator Code A - Not applicable as HCPCS priced under one methodology
HCPCS Anesthesia Base Unit Quantity 0
HCPCS Coverage Issues Manual Reference Section Number

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