2025 HCPCS Code M0236

Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administration monitoring, not otherwise classified, second dose

TAGS: systemic indication patients invasive corticosteroids extracorporeal receiving supplemental pediatric hospitalized oxygenation second products administration prophylaxis require membrane infusion antibody intravenous adults mechanical treatment monoclonal

Short DescriptionIntrav inf, mon anti, sec do
HCPCS Coverage Code C - Carrier judgment
HCPCS Action Code A - Add procedure or modifier code
HCPCS Action Effective Date October 01, 2025
HCPCS Code Added Date October 01, 2025
HCPCS Pricing Indicator Code 54 - Vaccinations
HCPCS Multiple Pricing Indicator Code A - Not applicable as HCPCS priced under one methodology
HCPCS Coverage Issues Manual Reference Section Number
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 Anesthesia Base Unit Quantity 0

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