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See a sample rate comparisonHCPCS Q0224 (Pemgarda) Fee Schedule
Last Verified: October 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 Fact | Detail |
|---|---|
| Service Type | Temporary Codes COVID-19 Infusion Therapy |
| Complexity Level | High |
| Medicaid Fee Schedule | View Medicaid rates for Q0224 |
| Medicare Payment Limit | $7239  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS Q0224 by major payers:
$7,078.56
$6,912.68
$16,339.05
$8,190.59
Compare published rates across providers.
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HCPCS Q0224
5 of 25 sample ratesHigher to lower in this preview
Piedmont Newton Ekg Billing LLC
Piedmont Newton Hospital Inc
$10,230.09Published rateAmanda Spies
Attigo Infusion Inc
$6,583.50Published rateKamran Rajaee
$6,583.50Published rateJulio Beras-Matos
Arthritis Associates, P.A.
$6,583.50Published rateLeanora Brissett
Attigo Infusion Inc
$6,583.50Published rate
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See a sample payer proposalHCPCS 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.
| Code | Complexity | Description |
|---|---|---|
| Q0224-HCPCS | High | 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 |
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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