HCPCS Code Q0224

Injection, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, and who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive medications or treatments, and are unlikely to mount an adequate immune response to covid-19 vaccination, 4500 mg

Miscellaneous Services (Temporary Codes)

Q0224 is a valid 2026 HCPCS code for Injection, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, and who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive medications or treatments, and are unlikely to mount an adequate immune response to covid-19 vaccination, 4500 mg or just “Inj, pemivibart, 4500 mg” for short, used in Pneumococcal/flu vaccine.

HCPCS Code Details - Q0224

HCPCS Level II Code
Miscellaneous Services (Temporary Codes)
HCPCS Code Q0224
Description

Long description:
Injection, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, and who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive medications or treatments, and are unlikely to mount an adequate immune response to covid-19 vaccination, 4500 mg

Short description:
Inj, pemivibart, 4500 mg

HCPCS Modifier1
HCPCS Pricing indicator 54 - Vaccinations
Multiple pricing indicator A - Not applicable as HCPCS priced under one methodology
Coverage code C - Carrier judgment
BETOS2 code O1G - Immunizations/Vaccinations
HCPCS Action code N - No maintenance for this code
Type of service V - Pneumococcal/flu vaccine
Effective date Effective Mar 22, 2024
Date added Added Mar 22, 2024
HCPCS Coding Procedures

HCPCS Modifiers

In HCPCS Level II, modifiers are composed of two alpha or alphanumeric characters.

Example: E0260-NU - Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress
“NU” identifies the hospital bed as new equipment

ASP Drug pricing - Q0224

Effective Code Dosage Payment
Limit		 Vaccine AWP % Vaccine Limit Infusion AWP % DME infusion limit Blood AWP % Blood limit Clotting factor Note
April 1, 2026 - June 30, 2026 4500 MG 7239 95% 7239 - - - -
January 1, 2026 - March 31, 2026 4500 MG 7239.000 95% 7239.000 - - - -
October 1, 2025 - December 31, 2025 4500 MG 7239 95% 7239 - - - -
Jul 1, 2025 - Sep 30, 2025 4500 MG 7239 95% 7239 - - - -
April 1, 2025 - June 30, 2025 4500 MG 6583.5 95% 6583.5 - - - -

See also

  • HCPCS Q0222 · Injection, bebtelovimab, 175 mg

  • HCPCS Q0235 · Injection, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, not otherwise classified, 1 mg

1 Two-digit numeric codes are Level I code modifiers copyrighted© by the American Medical Association's Current Procedural Terminology (CPT).

2 BETOS stands for “Berenson-Eggers Type Of Service”