Does J0248 require prior authorization?

Yes, J0248 requires prior authorization (high confidence). At least one active policy explicitly requires prior authorization.

What is the Medicare reimbursement rate for J0248?

Medicare facility rate: N/A. Non-facility rate: N/A. Work RVU: 0.00.

HCPCS/CPT

Prior Auth Required

At least one active policy explicitly requires prior authorization (high confidence)

Work RVU

0.00

Facility

N/A

Non-Facility

N/A

Remdesivir (Veklury) is medically necessary for the treatment of COVID-19 in adults and pediatric patients (birth to <18 years, weight ≥1.5 kg) who are hospitalized, or non-hospitalized with mild-to-moderate COVID-19 at high risk for progression to severe disease (hospitalization or death).
Remdesivir is medically necessary for treatment of COVID-19 in adults and pediatric patients birth to <18 years weighing ≥1.5 kg who are hospitalized, or non-hospitalized with mild-to-moderate COVID-19 and high risk for progression to severe disease (hospitalization or death).
Remdesivir is medically necessary for treatment of COVID-19 in adults and pediatric patients birth to <18 years weighing ≥1.5 kg who are hospitalized, or not hospitalized with mild-to-moderate COVID-19 at high risk for progression to severe disease (hospitalization or death).
Remdesivir (Veklury) is medically necessary for the treatment of COVID-19 in adults and pediatric patients birth to <18 years weighing at least 1.5 kg who are hospitalized, or not hospitalized with mild-to-moderate COVID-19 at high risk for progression to severe disease (including hospitalization or death).

ARKBLUE-REMDESIVIR-E-G-VEKLURY-F8BDE63DE6, Remdesivir (e.g., Veklury)

BCBSIL-RX501.130, Remdesivir

BCBSMT-RX501.130, Remdesivir

BCBSNM-RX501.130, Remdesivir

BCBSOK-RX501.130, Remdesivir

EVICORE-MEDICAL_DRUG-F33735C87409, Veklury (remdesivir)