Summary & Overview
HCPCS Q0244: Casirivimab and Imdevimab Injection, 1200 mg
HCPCS Level II code Q0244 denotes the administration of casirivimab and imdevimab, provided as a 1200 mg combined monoclonal antibody injection for passive immunotherapy. This code matters nationally because it standardizes billing for a high-cost biologic therapy used in outpatient infusion or ambulatory settings, affecting payer coverage decisions, reimbursement processes, and access to treatment. Public and private payers frequently develop specific policies around monoclonal antibody therapies, making accurate coding essential for claims processing and cost tracking.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will learn how this code is defined and used in clinical billing, typical sites of service where the therapy is delivered, and the scope of payers that commonly process claims for this service. The publication also outlines benchmarks and policy-relevant considerations for billing and reimbursement, summarizes typical clinical context for use of the therapy, and identifies areas where payers commonly publish coverage guidance.
Data not available in the input for associated taxonomies, ICD-10 diagnoses, related codes, and detailed payer-specific reimbursement rates. The content focuses on national relevance and operational implications for providers and billing professionals working with HCPCS Level II code Q0244.
Billing Code Overview
HCPCS Level II code Q0244 describes Injection, casirivimab and imdevimab, 1200 mg. This code represents administration of a combined monoclonal antibody therapy formulation dosed as 1200 mg of the two-antibody combination used for passive immunotherapy.
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Service type: Therapeutic monoclonal antibody injection
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Typical site of service: Infusion center, outpatient clinic, or other ambulatory care setting where intravenous or subcutaneous biologic therapies are administered
Clinical & Coding Specifications
Clinical Context
A patient aged 62 with symptomatic mild-to-moderate SARS-CoV-2 infection and one or more high-risk features (for example, obesity, diabetes mellitus, chronic kidney disease, immunocompromised state) presents to an outpatient infusion center within 7–10 days of symptom onset. The clinician documents a positive SARS-CoV-2 test and determines the patient meets emergency use criteria for monoclonal antibody therapy. The ordering provider (infectious disease specialist, emergency physician, or primary care clinician) places the order for Q0244 (injection, casirivimab and imdevimab, 1200 mg).
The clinical workflow includes screening for contraindications and prior monoclonal antibody receipt, obtaining informed consent, verifying patient identity and payor coverage, preparing and reconciling the product per manufacturer instructions, and administering the intravenous infusion in a monitored outpatient setting. The patient is observed for infusion-related reactions for at least 1 hour post-infusion, with nursing documentation of vital signs and any adverse events. If the infusion is administered as part of a same-day emergency department visit or observation stay, the claim may be appended with relevant modifiers to indicate service circumstances.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
78 | Return to the operating/procedure room for a related procedure during the global period |