Summary & Overview
HCPCS M0241: Casirivimab and Imdevimab Administration with Home Monitoring
HCPCS Level II code M0241 represents the administration of the monoclonal antibody combination casirivimab and imdevimab by intravenous infusion or subcutaneous injection in the beneficiary's home or residence, including post-administration monitoring. The code specifically covers subsequent repeat doses and encompasses services delivered in homes that were made provider-based to a hospital during the COVID-19 public health emergency. Nationally, this code matters for payers and providers as it documents in-home delivery of COVID-19–related monoclonal antibody therapy and associated monitoring, affecting billing processes and access to outpatient therapies.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of what M0241 denotes clinically and operationally, the typical site of service, and which payers are relevant. The publication outlines billing and policy considerations tied to in-home monoclonal antibody administration, provides benchmarking context where available, and summarizes recent policy developments related to home-based COVID-19 therapy administration. Data not provided in the input—such as associated taxonomies, ICD-10 codes, and related codes—are noted as unavailable.
Billing Code Overview
HCPCS Level II code M0241 describes the administration of casirivimab and imdevimab by intravenous infusion or subcutaneous injection, including the infusion or injection procedure and post-administration monitoring delivered in the home or residence. This code explicitly includes services provided in a beneficiary's home that has been made provider-based to a hospital during the COVID-19 public health emergency, and it applies to subsequent repeat doses.
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Service type: Therapeutic monoclonal antibody administration with observation
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Typical site of service: Patient's home or residence (including hospital provider-based homes during the COVID-19 public health emergency)
Data not available in the input for associated taxonomies, ICD-10 diagnoses, related codes, and service line.
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with multiple chronic conditions (for example, chronic obstructive pulmonary disease and type 2 diabetes) is diagnosed with early mild-to-moderate COVID-19 after a positive SARS-CoV-2 test and meets high-risk criteria for progression to severe disease. The patient is unable or prefers not to travel to an outpatient infusion center. A licensed clinician orders monoclonal antibody therapy consisting of casirivimab and imdevimab to be administered via intravenous infusion or subcutaneous injection at the patient’s home or residence. A qualified infusion nurse visits the home, performs pre-infusion assessment (vital signs, allergy review, informed consent confirmation), establishes IV access or prepares subcutaneous injections, administers the medication per protocol, and provides post-administration monitoring for infusion-related reactions for the required observation period. Documentation includes consent, medication lot numbers and doses, start and stop times, pre- and post-vital signs, any adverse events and interventions, and disposition. When the patient’s home has been made provider-based to the hospital during the public health emergency, billing follows the same code for home-based administration with monitoring. Subsequent repeat doses for the same therapeutic course are billed using the same HCPCS Level II code M0241 as specified for repeat administrations.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Unusual procedural services |