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CMS Issues New HCPCS Code for Remdesivir Antiviral Medication  

For CFOs, finance & reimbursement staff

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The Centers for Medicare & Medicaid Services (CMS) released a new Healthcare Common Procedure Coding System (HCPCS) code for VEKLURY™ (remdesivir) antiviral medication when administered in an outpatient setting.  

HCPCS code J0248 is available for use by all payers and is effective for dates of service on or after Dec. 23, 2021: 

  • Long descriptor: Injection, remdesivir, 1 mg 
  • Short descriptor: Injection, remdesivir, 1 mg 

The new code is in response to the recent statement from the National Institutes of Health COVID-19 treatment guidelines on therapies for the omicron variant. 

Medicare administrative contractors (MACs) determine Medicare coverage when there is no national coverage determination, including in cases when providers use FDA-approved drugs for indications other than what is on the approved label. Therefore, the MACs will determine Medicare coverage for HCPCS code J0248 for VEKLURY™ (remdesivir) administered in an outpatient setting and will share coverage and claims processing information for J0248.  

Providers should contact their MAC with any questions about coverage.