COVID-19 Vaccines and Monoclonal Antibodies
Refer to CMS COVID-19 Vaccines and Monoclonal Antibodies webpage for a full listing of the COVID-19 vaccine, administration and monoclonal antibodies codes, descriptions and effective dates.
Vaccine & Administration
Providers should refer to the Modifier SL – State Supplied Vaccinations Reimbursement Policy for guidelines for billing COVID-19 State Issued vaccines.
Vaccine Administration At Home
Effective June 8, 2021, CMS established a new Healthcare Common Procedure Coding System (HCPCS) code, M0201, to report for an additional payment when COVID-19 vaccines are administered to patients that have difficulties leaving their homes or are hard-to-reach. HCPCS M0201 is reported in addition to the existing product-specific COVID-19 vaccine administration codes (e.g., 0001A, 0002A, 0011A, 0012A, 0031A) when administered in the home.
- This code can only be used if the sole purpose of the visit is for vaccine administration.
- M0201 can only be used once per home per date of service.
- If the vaccine is given to more than one person in the home on the same day, only one claim for M0201 may be filed.
Monoclonal Antibody Infusion and Administration
The U.S. Food and Drug Administration (FDA) issued an Emergency Use Authorization (EUA) for the investigational monoclonal antibody therapy. These monoclonal antibody therapies are for the treatment of mild-to-moderate COVID-19 in adults and pediatric patients with positive COVID-19 test results who are at high risk for progressing to severe COVID-19 and/or hospitalization.