Outpatient Coverage of Remdesivir for COVID-19 for all CareFirst Members

In view of supply shortages for current COVID-19 therapeutic treatments, effective January 12, 2022, through February 15, 2022, CareFirst is covering a three-day hospital outpatient course of VEKLURY (Remdesivir) infusion.

  • No prior authorization is required.
  • Normal cost sharing and benefit limitations will apply.
  • CMS has created HCPS code J0248 for Remdesivir when delivered in an outpatient setting.

This coverage applies to all CareFirst members: Commercial, Federal Employee Program, Medicaid, Dual Eligible Special Needs, and Medicare Advantage. We will reassess treatment options and availability in mid-February.

Read the NIH COVID-19 Treatment Guidelines Panel’s Statement on Therapies for High-Risk, Non-Hospitalized Patients with Mild to Moderate COVID-19.

In Case You Missed It

CareFirst is aware of the new federal direction requiring coverage of over-the-counter testing kits. We anticipate guidance will be available for members and providers in the coming days.

For the latest on our COVID response and policies, visit our Coronavirus Resource Center.