CMS updates monoclonal antibody billing and payment FAQ

The Centers for Medicare & Medicaid Services yesterday updated its FAQs regarding coverage, billing and payment for monoclonal antibody therapies used to treat COVID-19.

Topics discuss what happens if a product loses emergency use authorization status; how long Medicare will pay for monoclonal antibody COVID-19 products for treatment and administration under Medicare Part B; which billing codes to use; cost-sharing obligations and reimbursement options for beneficiaries covered by both Medicare and Medicaid; and how Medicare will pay entities such as skilled nursing facilities.

The FAQ also includes an infographic with facts about expected Medicare payment to providers and how Medicare beneficiaries can receive these treatments with no cost-sharing.

In other news, CMS said it will allow laboratories and COVID-19 testing sites to use SARS-CoV-2 test kits, reagents and swabs that are expired. However, the updated Clinical Laboratory Improvement Amendments guidelines state, “Under no circumstances, however, should a laboratory adopt policies that would allow for the regular use of expired reagents,” and expired supplies should only be used until non-expired equivalents are available.