Q0221 HCPCS code: Injection, tixagevimab and cilgavimab, for the pre-exposure prophylaxis only, for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) with no known sars-cov-2 exposure, who either have moderate to severely compromised immune systems or for whom vaccination with any available covid-19 vaccine is not recommended due to a history of severe adverse reaction to a covid-19 vaccine(s) and/or covid-19 vaccine component(s), 600 mg
Q0221 is the HCPCS Level II code for injection, tixagevimab and cilgavimab, for the pre-exposure prophylaxis only, for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) with no known sars-cov-2 exposure, who either have moderate to severely compromised immune systems or for whom vaccination with any available covid-19 vaccine is not recommended due to a history of severe adverse reaction to a covid-19 vaccine(s) and/or covid-19 vaccine component(s), 600 mg. CMS terminated Q0221 on 2024-12-12; do not bill it for later dates of service. In 2023 Medicare paid an average of $0.01 per service for Q0221 across 123 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. Medicare volume fell 97% from 2022 to 2023 (3,840 to 123 services). In 2023, about 69 clinicians billed Medicare for Q0221 for 123 beneficiaries.
Code details
| Field | Value |
|---|---|
| Section | Q codes — Temporary codes |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 54 |
| BETOS category | O1G — Immunizations/vaccinations |
| Added | 2022-02-24 |
| Last action effective | 2024-12-13 |
| Terminated | 2024-12-12 |
Who bills Q0221 (2023)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 69 |
| Medicare beneficiaries | 123 |
| States with claims | 3 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for Q0221, 2022–2023
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 3,840 | 3,534 | $0.01 | $0.01 |
| 2023 | 123 | 123 | $0.01 | $0.01 |
States with the most Q0221 services (2023)
| State | Services | Avg. paid |
|---|---|---|
| California | 24 | $0.01 |
| Pennsylvania | 17 | $0.01 |
| Florida | 12 | $0.01 |
What changed for Q0221
- 2022-02-24: Q0221 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code Q0221?
Q0221 is the HCPCS Level II code for injection, tixagevimab and cilgavimab, for the pre-exposure prophylaxis only, for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) with no known sars-cov-2 exposure, who either have moderate to severely compromised immune systems or for whom vaccination with any available covid-19 vaccine is not recommended due to a history of severe adverse reaction to a covid-19 vaccine(s) and/or covid-19 vaccine component(s), 600 mg. Short descriptor: "Tixagev and cilgav, 600mg".
How much does Medicare pay for Q0221?
In 2023, the average Medicare payment was $0.01 per service (average allowed $0.01).
Does Medicare cover Q0221?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Related Q02 codes
- Q0220 — Injection, tixagevimab and cilgavimab, for the pre-exposure prophylaxis only, for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) with no known sars-cov-2 exposure, who either have moderate to severely compromised immune systems or for whom vaccination with any available covid-19 vaccine is not recommended due to a history of severe adverse reaction to a covid-19 vaccine(s) and/or covid-19 vaccine component(s), 300 mg
- Q0222 — Injection, bebtelovimab, 175 mg
- Q0224 — Injection, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, and who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive medications or treatments, and are unlikely to mount an adequate immune response to covid-19 vaccination, 4500 mg
- Q0234 — Injection, tocilizumab-bavi, 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, 1 mg
- Q0235 — Injection, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ECMO) only, not otherwise classified, 1 mg
- Q0237 — Injection, tocilizumab-anoh, 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 (ECMO) only, 1 mg
- Q0238 — Injection, tocilizumab-aazg, 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 (ECMO) only, 1 mg
- Q0239 — Injection, bamlanivimab-xxxx, 700 mg
- Q0240 — Injection, casirivimab and imdevimab, 600 mg
- Q0243 — Injection, casirivimab and imdevimab, 2400 mg
- Q0244 — Injection, casirivimab and imdevimab, 1200 mg
- Q0245 — Injection, bamlanivimab and etesevimab, 2100 mg
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Next steps
- Run a reimbursement report for a device billed under Q0221
- Watch Q0221 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for Q0221
Sources: CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.