CMS has increased Medicare payment for administering monoclonal antibodies to treat beneficiaries with COVID-19, continuing coverage under the Medicare Part B COVID-19 Vaccine Benefit. This means more providers and suppliers are readily able to administer these treatments. Beneficiaries are not responsible for any cost sharing, regardless of where the service is furnished – including in a physician’s office, other healthcare facility or at home.
The national average payment rate has increased from $310 to $450 for most health care providers. In support of providers’ efforts to prevent the spread of COVID-19, CMS will also establish a higher national payment rate of $750 for at-home monoclonal antibodies treatment.
See updated toolkits for providers, states and insurers to help the health care system swiftly administer monoclonal antibody treatment with these new Medicare payment rates, here. The COVID-19 Frequently Asked Questions (FAQs) on Medicare Fee-for-Service (FFS) Billing document was also updated here (see section BB).
In addition, CMS is updating coding resources for providers. More information can be found here.
For additional clinical information about COVID-19 monoclonal antibodies, please visit: