Coverage of and Payment for the Administration of Remdesivir in an Outpatient Setting

As described in All-Provider Bulletin 336, effective for dates of service on or after December 22, 2021, MassHealth will reimburse MassHealth-enrolled acute outpatient hospitals, community health centers, and physicians for the administration of Remdesivir (Veklury) in an outpatient setting. Providers administering Remdesivir should bill MassHealth using the existing HCPCS code J3490.

In May 2022, MassHealth formally replaced HCPCS code J3490 with HCPCS code J0248. Eligible providers may bill for the administration of Remdesivir (Veklury) using HCPCS code J0248 for dates of service on or after April 1, 2022. MassHealth updated its system to reflect the coding changes effective for dates of service on or after April 1, 2022. All affected claims will be reprocessed and will appear on this or future remittance advices.

If you have questions, please contact the MassHealth Customer Service Center at providersupport@mahealth.net or (800) 841-2900.