Monoclonal Antibody Authorization from the FDA (Updated 02/09/21) & MaineCare Reimbursement
FDA
Authorizes Monoclonal Antibodies for Treatment of COVID-19 (Guidance Document 02/11/21)
The U.S.
Food and Drug Administration issued an emergency use authorization
(EUA) this week for bamlanivimab and etesevimab administered together
for the treatment of mild to moderate COVID-19 in adults and pediatric patients
(12 years of age or older weighing at least 40 kilograms [about 88 pounds]) who
test positive for SARS-CoV-2 and who are at high risk for progressing to severe
COVID-19. The authorized use includes treatment for those who are 65 years of
age or older or who have certain chronic medical conditions.
Maine Care Claims for Monoclonal
Antibody Product and Infusion Codes, CR 99700 (Updated
02/10/21)
Providers of MaineCare Benefits
Manual, Section 90 and Section 45 services may submit claims for the delivery
of Monoclonal Antibody COVID-19 Infusion treatments when they are delivered on
or after the respective effective dates for each product and in accordance with
the for each product.
Please review the Fact Sheets for
Health Care Providers of EUA of Bamlanivimab and Casirivimab & Imdevimab for the limitations of authorized
use.
More
information on various codes and their rates can be found here.
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