The Centers for Medicare & Medicaid Services (CMS) issued a new Healthcare Common Procedure Coding System (HCPCS) code for the antiviral medication VEKLURYTM (remdesivir) when administered in the outpatient setting. The new code is in response to the recent statement from the National Institutes of Health (NIH) COVID-19 Treatment Guidelines Panel regarding therapies for the COVID-19 Omicron variant.

At the national level, adding social needs data to hospital claims enables system-wide research to gain a better understanding of the health-related social needs of patients and communities around the country. Federal programs could be tailored to meet those needs. Furthermore, as payment moves from volume to value, having claims data connected to social needs can support policy and payment reforms, including appropriate risk-adjustments.

This code is available for use by all payers and is effective for dates of service on or after December 23, 2021:

  • Long descriptor: Injection, remdesivir, 1 mg
  • Short descriptor: Inj, remdesivir, 1 mg

Your Medicare Administrative Contractor (MAC) will share coverage and claims processing information for J0248.

Source: U.S. Centers for Medicare & Medicaid Services (CMS)

 

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