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: immunosuppressive certain weighing condition response mount prophylaxis receipt known older years adequate medical compromise adolescents immune unlikely medications either least

Short Description	Inj, pemivibart, 4500 mg
HCPCS Action Code	A - Add procedure or modifier 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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