MedicaidBilling CodesMedium impact
MAB2022022401
Pennsylvania Medicaid (DHS)·PA · Infectious Disease, Family Medicine, Internal Medicine +1 more·Provider Bulletin
Effective date
Dec 8, 2021
We identified it
Jun 20, 2026
Summary
Pennsylvania Medical Assistance (Medicaid) has updated fee schedules for COVID-19 monoclonal antibody administration codes, adding new codes M0220 and M0221 for Tixagevimab and Cilgavimab pre-exposure prophylaxis. The policy consolidates all current monoclonal antibody billing codes with their respective reimbursement rates, ranging from $120.40 to $600.00 depending on location of service.
Action Required
Immediately: Billing team must update fee schedules for Pennsylvania Medicaid to include new codes M0220 ($120.40) for in-clinic administration and M0221 ($200.40) for home administration of Tixagevimab and Cilgavimab pre-exposure prophylaxis. Verify all other monoclonal antibody codes (M0240-M0248) have correct reimbursement rates loaded in billing system. Only applies to PA Medicaid Fee-for-Service patients.