News: New treatment codes for COVID-19 take effect in July 2026

CMS established three Level II Healthcare Common Procedure Coding System (HCPCS) codes to bill for TOFIDENCE®, a biosimilar to ACTEMRA®, when used to treat COVID-19, according to the latest update to the Vaccine Administration National Fee Schedule.

TOFIDENCE was approved by the FDA in July 2024 for intravenous administration in hospitalized adults with COVID-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation.

Effective July 1, organizations can use HCPCS codes Q0234 to bill for the product, as well as HCPCS codes M0231 (first dose) and M0232 (second dose) to bill for the administration.

With this update, CMS noted that facilities could bill by reporting the not-otherwise-classified (NOC) COVID-19 monoclonal antibody HCPCS product code (Q0235) and associated administrative codes (M0235 and M0236). Introduced in October 2025, these NOC codes are used to bill FDA-approved products not yet assigned to a unique HCPCS Level II code. Facilities should use the most specific code when one is available.

Editor’s note: To read the full update from CMS, click here. To read additional coverage from the Revenue Integrity Insider, click here.