Summary & Overview
HCPCS M0244: Casirivimab and Imdevimab Home Infusion/Injection with Monitoring
HCPCS Level II code M0244 represents the administration and post-administration monitoring of the monoclonal antibody combination casirivimab and imdevimab when given by intravenous infusion or subcutaneous injection in a patient’s home or residence. This code is significant nationally because it formalizes billing for home-based therapeutic monoclonal antibody delivery, a care setting expanded during the COVID-19 public health emergency and relevant to ongoing home infusion services.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the clinical service captured by the code, the typical site of service, and the service type. The publication provides benchmarks and coverage context where available, notes policy updates affecting home-based monoclonal antibody administration, and outlines the clinical context for use of casirivimab and imdevimab in outpatient/home settings.
This summary is intended for a national audience of policy analysts, billing managers, and clinical program leads who need a concise description of what M0244 covers, which payers are relevant, and what aspects of billing and policy to consider when delivering home-based monoclonal antibody therapy. Data not available in the input will be noted in appropriate sections.
Billing Code Overview
HCPCS Level II code M0244 describes an intravenous infusion or subcutaneous injection of casirivimab and imdevimab, and includes the administration and required post-administration monitoring when provided in the home or residence. The description explicitly includes care delivered in a beneficiary's home that has been made provider-based to the hospital during the COVID-19 public health emergency.
Service type: Therapeutic monoclonal antibody administration with monitoring in the home setting
Typical site of service: Patient's home or residence (including homes made provider-based to a hospital during the COVID-19 public health emergency)
Clinical & Coding Specifications
Clinical Context
A high-risk adult patient with recent confirmed SARS-CoV-2 infection, mild-to-moderate COVID-19 symptoms, and risk factors for progression (for example age >65, immunocompromise, chronic lung disease, or obesity) receives a single-dose monoclonal antibody therapy consisting of casirivimab and imdevimab via intravenous infusion or subcutaneous injection in the patient’s home. The clinical workflow begins with a remote or ambulatory assessment by a treating clinician (telehealth or in-office) who documents symptom onset, positive COVID-19 test, and qualifying risk factors. A home infusion team from a hospital or outpatient infusion provider arranges a home visit; the medication is prepared per facility protocol, transported under appropriate cold chain conditions, and administered in the residence. The encounter includes pre-administration verification of identity and consent, baseline vital signs and oxygen saturation, administration of the monoclonal antibody by an appropriate clinician or infusion nurse, and a post-administration monitoring period (typically 60 minutes) to observe for infusion reaction or anaphylaxis. Documentation includes start and stop times, lot numbers, administered route (intravenous infusion or subcutaneous injection), and any adverse events. Billing uses M0244 to capture the infusion/injection plus post-administration monitoring delivered in the home or other residence, including instances when the beneficiary’s home was made provider-based to the hospital during the public health emergency.
Coding Specifications
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