• View CMS established codes and reimbursement rates for monoclonal antibodies and their administration.
• View the Office of the Assistant Secretary for Preparedness and Response national map of locations that have received shipments of the monoclonal antibody therapeutics.
• Bebtelovimab can now be purchased commercially through AmerisourceBergen.

For dates of service on or after May 12, 2023:

• COVID-19 testing performed in the provider’s office will be covered at regular plan cost shares for in- and out-of-network services.
• Out-of-network COVID-19 testing claims will be priced at allowed amounts rather than a negotiated or cash price. Balance billing may apply for commercial members, depending on the service.
• We will no longer cover over-the-counter (OTC) tests. Some Medicare Advantage members have OTC benefits that cover purchasing test kits.

View our COVID-19 Testing (Laboratory #74) medical policy.