MedicaidBilling CodesMedium impact
MAB2022050901
Pennsylvania Medicaid (DHS)·PA · Family Medicine, Internal Medicine, Emergency Medicine +2 more·Provider Bulletin
Effective date
Feb 11, 2022
We identified it
Jun 20, 2026
Summary
Pennsylvania Medicaid has added two new CPT codes (M0222 and M0223) for billing Bebtelovimab monoclonal antibody administration for COVID-19 treatment, effective February 11, 2022. The codes have different reimbursement rates for facility ($280.40) versus home administration ($440.40).
Action Required
Immediately for Pennsylvania Medicaid providers: Add CPT codes M0222 ($280.40 for facility administration) and M0223 ($440.40 for home/residence administration) to billing system for Bebtelovimab monoclonal antibody treatments. Update encounter forms and train staff on proper code selection based on administration location. Ensure claims include appropriate National Drug Code only if provider paid for the product (federal government supplies are billed at no cost). Limit billing to once per day per code.