Part B Insider (Multispecialty) Coding Alert

You can expect a little more money in your pocket when you administer monoclonal antibody infusions to Medicare beneficiaries with COVID-19, says the Centers for Medicare & Medicaid Services (CMS) in a May 6 release on the change.

Now: Nationally, the average payment will go up from $310 to $450 in most healthcare locales, CMS indicates. The agency also plans to “establish a higher national payment rate of $750 when monoclonal antibodies are administered in the beneficiary’s home, including the beneficiary’s permanent residence or temporary lodging (e.g., hotel/motel, cruise ship, hostel, or homeless shelter),” the release notes.

Why? Fresh data on the costs of administering COVID treatments to sick patients were a big part of the informed decision CMS made to boost the payment rates, the agency says.

CMS has also updated its coding resources, which lists the various monoclonal antibody treatments, CPT^® codes, effective dates, and new payment allowances.

Access the chart at www.cms.gov/medicare/medicare-part-b-drug-average-sales-price/covid-19-vaccines-and-monoclonal-antibodies.

 

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