2025 HCPCS Code 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

TAGS: adolescents adequate years medications receipt least unlikely condition older mount known prophylaxis certain immunosuppressive immune adults either weighing compromise medical response
Short DescriptionInj, pemivibart, 4500 mg
HCPCS Action Code N - No maintenance for this code
HCPCS Coverage Code C - Carrier judgment
HCPCS Code Added Date March 22, 2024
HCPCS Action Effective Date March 22, 2024
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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