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Addition of Monoclonal Antibody Therapy Procedure Codes M0247, Q0247 and Q0244 Approved for the Treatment of COVID-19 Through Emergency Use Authorization

Last updated on 7/15/2021

Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to eligible clients. Administrative procedures such as prior authorization, pre-certification, referrals, and claims/encounter data filing may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should contact the client's specific MCO for details.

On May 26, 2021, the U.S. Food and Drug Administration (FDA) issued an emergency use authorization (EUA) for the investigational monoclonal antibody therapy, Sotrovimab, for the treatment of mild-to-moderate COVID-19. 

On June 3, 2021, the FDA issued a revised EUA for Regeneron’s COVID-19 monoclonal antibody combination product casirivimab and imdevimab. The updated EUA includes a new dosing regimen (1200 mg vs. 2400 mg).

Effective June 18, 2021, for dates of service on or after May 26, 2021, procedure codes M0247 (administration of sotrovimab) and Q0247 (sotrovimab) have been added for Texas Medicaid and the Children with Special Health Care Needs (CSHCN) Services Program. Effective June 18, 2021, for dates of service on or after June 3, 2021, procedure code Q0244 (casirivimab and imdevimab with updated dosing regimen) has been added as informational for Texas Medicaid and the CSHCN Services Program.

The Food and Drug Administration (FDA) approved the use of these monoclonal antibody therapy drugs for treatment of mild-to-moderate COVID-19.

Procedure code Q0244 is informational only while being distributed to providers free of charge effective June 3, 2021.

Procedure codes M0247 and Q0247 are benefits for clients who are 12 years of age and older, weigh at least 40kg, and restricted to diagnosis code U071.

Procedure codes M0247 and Q0247 are benefits for the following providers and places of service:

Place of Service

Provider Type


Physician, Physician Groups, Physician Assistant, Nurse Practitioner, Clinical Nurse Specialist

Outpatient Hospital

Hospital Providers

Note: Procedure codes M0247 and Q0247 will not be reimbursed until expenditures are approved and the rates are adopted by Texas Medicaid. Providers will be notified of any benefit changes in a future article.

Services provided before the expenditures are approved will receive the following explanation of benefits (EOB) 02008 notification:

“This procedure code has been approved as a benefit pending the approval of expenditures. Providers will be notified of the effective dates of service in a future notification if expenditures are approved.”

For more information, call the TMHP Contact Center at 800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 800-568-2413.