HCPCS M0231 is officially defined as "Intravenous infusion, tocilizumabbavi, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation only, includes infusion and post administration monitoring, first dose." HCPCS M0231 is referenced in 1 tracked payer policy change from Blue Cross Blue Shield of Rhode Island. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS M0231 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.
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