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Is there a new HCPCS code for the recently authorized higher dosage of EVUSHELD?

Yes.  EVUSHELD is a combination product of tixagebimab and cilgavimab that is used as a pre-exposure prophylactic treatment for COVID-19.  On March 10, 2022, CMS announced the creation of new HCPCS code Q0221 to represent the recently authorized higher dosage of EVUSHELD (600 mg as compared to the previously authorized 300 mg dose which will continue to be reported with HCPCS code Q0220).  The effective date for Q0221 is February 24, 2022, which coincides with the date the Emergency Use Authorization was updated by the FDA.

We have provided the long and short descriptors for new HCPCS code Q0221 below for your convenience.

Long Descriptor: Injection, tixagevimab and cilgavimab, for the pre-exposure prophylaxis only, for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) with no known sars-cov-2 exposure, who either have moderate to severely compromised immune systems or for whom vaccination with any available covid-19 vaccine is not recommended due to a history of severe adverse reaction to a covid-19 vaccine(s) and/or covid-19 vaccine component(s), 600 mg

Short Descriptor: Tixagev and cilgav, 600mg

CMS has instructed the provider community to use HCPCS codes M0220 and M0221 to report the administration of new code Q0221.  Both of these administration codes were also previously announced and have been effective since 12/8/2021.  Note, HCPCS codes M0220 and M0221 will also continue to be used to report administration of the lower dosage of EVUSHELD reported with HCPCS code Q0220.

M0220: Tixagev and cilgav inj

M0221: Tixagev and cilgav inj hm

MLN Connects, dated 3/10/2022:
https://www.cms.gov/outreach-and-educationoutreachffsprovpartprogprovider-partnership-email-archive/2022-03-10-mlnc#_Toc97643823

EVUSHELD Fact Sheet:
https://www.fda.gov/media/154701/download

COVID-19 Monoclonal Antibodies web page:
https://www.cms.gov/medicare/medicare-part-b-drug-average-sales-price/covid-19-vaccines-and-monoclonal-antibodies

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