NOTICES
DEPARTMENT OF HUMAN SERVICES
Addition of Monoclonal Antibody Product Bebtelovimab to the Medical Assistance Program Fee Schedule
[52 Pa.B. 2924]
[Saturday, May 14, 2022]In accordance with 55 Pa. Code § 1150.61(a) (relating to guidelines for fee schedule changes), the Department of Human Services (Department) announces the addition of the following Current Procedural Terminology (CPT) codes to the Medical Assistance (MA) Program Fee Schedule for the administration of the SARS-CoV-2 monoclonal antibody product Bebtelovimab for the treatment of SARS-CoV-2. The effective date and MA Fee for each code is indicated as follows.
Procedure Code Description Effective Date MA Fee M0222 Intravenous injection, Bebtelovimab, includes injection and post administration monitoring 2/11/22 $280.40 M0223 Intravenous injection, Bebtelovimab, includes injection and post administration monitoring in the home or residence; this includes a beneficiary's home that has been made provider-based to the hospital during the COVID-19 public health emergency 2/11/22 $440.40 The MA Program Fee Schedule has been updated with the new CPT codes previously noted to allow for payment of the administration of SARS-CoV-2 monoclonal antibody products to an MA beneficiary for treatment of SARS-CoV-2.
The Department issued an MA Bulletin to inform providers enrolled in the MA Program of the addition of the CPT codes previously noted for the administration of the SARS-CoV-2 monoclonal antibody product Bebtelovimab to an MA beneficiary for the treatment of SARS-CoV-2.
Fiscal Impact
There is no fiscal impact associated with the addition of these codes.
Public Comment
Interested persons are invited to submit written comments regarding this notice to the Department of Human Services, Office of Medical Assistance Programs, c/o Regulations Coordinator, Room 515, Health and Welfare Building, Harrisburg, PA 17120. Comments received within 30 days will be reviewed and considered for any subsequent revision to the MA Program Fee Schedule.
Persons with a disability who require an auxiliary aid or service may submit comments using the Pennsylvania Hamilton Relay Service at (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).
MEG SNEAD,
Acting SecretaryFiscal Note: 14-NOT-1513. No fiscal impact; (8) recommends adoption.
[Pa.B. Doc. No. 22-705. Filed for public inspection May 13, 2022, 9:00 a.m.]
No part of the information on this site may be reproduced for profit or sold for profit.This material has been drawn directly from the official Pennsylvania Bulletin full text database. Due to the limitations of HTML or differences in display capabilities of different browsers, this version may differ slightly from the official printed version.
