Effective with date of service Dec. 9, 2021, North Carolina Medicaid and NC Health Choice programs cover Evusheld™ (600 mg) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code Q0221 - 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.
Evusheld 300mg should be billed with HCPCS code Q0220. All aspects of billing Q0221 Evusheld 600 mg will be the same as seen in SPECIAL BULLETIN COVID-19 #209 for Q0220 Evusheld 300 mg.
Contact
NCTracks Contact Center: 800-688-6696