M0232 Inf tocilizumab-bavi 2nd dos

Intravenous infusion, tocilizumabbavi, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation only, includes infusion and post administration monitoring, second dose

Medicare pricing for M0232

Physician Fee Schedule (CY 2026, RVU26D)

Status X: statutory exclusion, not paid under the PFS.

Payer policies and prior authorization for M0232

3 of 3 payer prior-auth lists that name M0232 require prior authorization or set conditions: Cigna.

PayerPlanStatePrior authConditionsSinceSource
CignaACA/IFPAllprior auth requiredJul 1, 2026Master Precertification List (For Health Care Providers)
CignaBasic StandardAllprior auth requiredJul 1, 2026Master Precertification List (For Health Care Providers)
CignaComplete/PHS+/PreferredAllprior auth requiredJul 1, 2026Master Precertification List (For Health Care Providers)

Payer coverage policies that name M0232

M0232 appears in 1 coverage policy from Blue Cross & Blue Shield of Rhode Island.

PayerPolicyRole in policyReviewedDocument
Blue Cross & Blue Shield of Rhode IslandCOVID-19 Monoclonal Antibody Treatment and Antiviral IV Medications
invasive mechanical ventilation, or | Reimbursed | Reimbursed		listed, no stanceJun 11, 2026payer document

Medicaid fee-for-service

  • AZ: $326.61 (outpatient_hospital), effective Jul 1, 2026
  • MS: $450.50 (comprehensive), effective Jul 1, 2026
  • ND: $0.00 (physician), effective Aug 1, 2026
  • VT: $342.38 (outpatient_hospital_opps), effective Jul 1, 2026

From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.