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HCPCS Q0224 (Pemgarda) Fee Schedule

Last Verified: July 2026

Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.

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
Key FactDetail
Service Type

Temporary Codes

COVID-19 Infusion Therapy

Complexity LevelHigh
Medicare Payment Limit
$7239BuyandBill.com
WAC Price
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National average reimbursement for HCPCS Q0224 by major payers:

bcbs

$7,078.56

uhc

$6,912.68

aetna

$16,339.05

cigna

$8,190.59

Preview provider-level rates for...
For billing codeHCPCS Q0224
PayerCodeRateNPITax IDStateSpecialty
United
Q0224$6583.501962435792 - HOUSTON HOSPITALS INC, HOUSTON MEDICAL CENTER711045290 - (GA) HOUSTON HOSPITALS INCGAGeneral Acute Care Hospital (282N00000X)
United
Q0224$6930.001922178789 - SCOTTISH RITE CHILDRENS MEDICAL CTR, CHILDREN'S HEALTHCARE OF ATLANTA AT SCOTTISH RITE580572465 - CHILDRENS HEALTHCARE OF ATLANTA INCGAChildren's Hospital (282NC2000X)
United
Q0224$6583.501669769782 - JULIO BERAS-MATOS562613565 - (TX) ARTHRITIS ASSOCIATES, P.A.TXRheumatology Physician (207RR0500X)
United
Q0224$6583.501104900646 - CHRISTINE HARMS843505937 - (TX) ATTIGO INFUSION INCTXPhysician Assistant (363A00000X)
United
Q0224$6583.501598360489 - AMANDA SPIES843505937 - (TX) ATTIGO INFUSION INCTXFamily Nurse Practitioner (363LF0000X)
United
Q0224$6583.501669475737 - MARVIN FOJTASEK843505937 - (TX) ATTIGO INFUSION INCTXInfectious Disease Physician (207RI0200X)
United
Q0224$6583.501851988604 - CHERISHE MONDICS843505937 - (TX) ATTIGO INFUSION INCTXNurse Practitioner (363L00000X)
United
Q0224$6583.501043785744 - BROOKE CALDWELL843505937 - (TX) ATTIGO INFUSION INCTXAdult Health Nurse Practitioner (363LA2200X)
United
Q0224$6583.501295233575 - LISA OSBUN843505937 - (TX) ATTIGO INFUSION INCTXFamily Nurse Practitioner (363LF0000X)
United
Q0224$6583.501104539071 - ALIYAH WAGGNER843505937 - (TX) ATTIGO INFUSION INCTXFamily Nurse Practitioner (363LF0000X)
United
Q0224$6583.501841651056 - KAMRAN RAJAEE273818647GAGeneral Acute Care Hospital (282N00000X)
United
Q0224$10230.091255891958 - PIEDMONT NEWTON EKG BILLING LLC814475074 - (GA) PIEDMONT NEWTON HOSPITAL INCGAGeneral Acute Care Hospital (282N00000X)
United
Q0224$6583.501003596248 - SHELBY MOSES843505937 - (TX) ATTIGO INFUSION INCTXFamily Nurse Practitioner (363LF0000X)
United
Q0224$6583.501386373306 - FE ANN BRAXTON843505937 - (TX) ATTIGO INFUSION INCTXFamily Nurse Practitioner (363LF0000X)
United
Q0224$10230.091306136551 - UJUKA ILOABUCHI881014763GAWomen's Hospital (282NW0100X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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HCPCS Q0224 vs. Other COVID-19 Infusion Therapy Codes

The HCPCS Q0224 code is part of the Temporary Codes services used for COVID-19 Infusion Therapy. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The HCPCS Q0224 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

CodeComplexityDescription
Q0224-HCPCSHighInjection, 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

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS Q0224. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the Q0224 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.

Factors that affect fee schedules


Medicare & Medicaid Rates

Government-set reimbursement amounts


Private Insurance Rates

Negotiated rates between providers and insurance companies


Geographic Location

Costs may be higher in urban areas.


Provider Type

Hospital providers may have different rates than private practice.

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