Injection, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg
Miscellaneous Services (Temporary Codes)
Q0249 is a valid 2026 HCPCS code for Injection, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg or just “Tocilizumab for covid-19” for short, used in Pneumococcal/flu vaccine.
| HCPCS Level II Code Miscellaneous Services (Temporary Codes) |
|
| HCPCS Code | Q0249 |
|---|---|
| Description |
Long description:
Short description: |
| 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 Jun 24, 2021 |
| Date added | Added Jun 24, 2021 |
| HCPCS Coding Procedures | |
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
| 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 | 1 MG | 7.569 | 95% | 7.569 | - | - | - | - | ||
| January 1, 2026 - March 31, 2026 | 1 MG | 7.569 | 95% | 7.569 | - | - | - | - | ||
| October 1, 2025 - December 31, 2025 | 1 MG | 7.569 | 95% | 7.569 | - | - | - | - | ||
| Jul 1, 2025 - Sep 30, 2025 | 1 MG | 7.569 | 95% | 7.569 | - | - | - | - | ||
| April 1, 2025 - June 30, 2025 | 1 MG | 7.569 | 95% | 7.569 | - | - | - | - |
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”
See COVID-19 vaccine pricing webpage for payment effective dates
See COVID-19 vaccine pricing webpage for payment effective dates
See COVID-19 vaccine pricing webpage for payment effective dates
See COVID-19 vaccine pricing webpage for payment effective dates
See COVID-19 vaccine pricing webpage for payment effective dates