HCPCS code M0249 — Adm tocilizu covid-19 1st. Status: Active. Effective Jun 24, 2021. Source: CMS HCPCS Level II.

M0249

Active

Adm tocilizu covid-19 1st

Intravenous infusion, 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, includes infusion and post administration monitoring, first dose

Category: Medical Services
Section: M-codes: Medical Services
Effective: Jun 24, 2021
Code type: alphanumeric
OPPS Status: S — Significant procedure — not subject to multiple procedure reduction
OPPS APC: 1506

MUE — Medically Unlikely Edits

Maximum units of M0249 Medicare will pay for one beneficiary on one date of service. Claims exceeding the MUE are denied or returned for review.

Service Type Max Units / Day
Outpatient Hospital 1
Practitioner Services 1

Source: CMS Medicare NCCI Medically Unlikely Edits

Change History

Quarterly changes published by CMS. Revisions may affect the code description, coverage, or rate — review each quarter's changes before submitting claims.

  • New Code 2021-Q2
    Adm tocilizu covid-19 1st