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HCPCS M0220: Tixagevimab and Cilgavimab Injection for Pre-Exposure Prophylaxis
HCPCS Level II code M0220 designates the injection of tixagevimab and cilgavimab for pre-exposure prophylaxis against SARS‑CoV‑2 in eligible individuals, including the injection and post-administration monitoring. This code matters nationally as monoclonal antibody prophylaxis remains a treatment option for people with moderate to severely compromised immune systems and for those with contraindications to available COVID‑19 vaccines. Billing clarity for M0220 affects access to prophylactic therapy and consistent coverage across commercial and public payers.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical indication and service context for M0220, payer coverage considerations, common billing modifiers, and typical sites of service. The publication summarizes policy-relevant points that influence reimbursement and coding accuracy, highlights clinical context for eligible patient populations, and notes where input data is not available. This resource is intended to support billing teams, clinicians, and policy stakeholders seeking a national perspective on coding and coverage for monoclonal antibody pre-exposure prophylaxis.
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Billing Code Overview
HCPCS Level II code M0220 describes the administration of tixagevimab and cilgavimab as a single service for pre-exposure prophylaxis against SARS‑CoV‑2 for certain adults and pediatric patients (ages 12 and older, weighing at least 40 kg). The description covers the injection itself and the required post-administration monitoring period.
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Service Type: Monoclonal antibody injection for COVID-19 pre-exposure prophylaxis
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Typical Site of Service: Outpatient clinic, infusion center, physician office, pharmacy-based clinic, or other ambulatory care settings where injections and post-administration monitoring are provided
Data not available in the input.