M0246 Insurance Policy Changes

HCPCS M0246 is officially defined as "Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring in the home or residence; this includes a beneficiary's home that has been made provider based to the hospital during the covid 19 public health emergency." HCPCS M0246 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 M0246 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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