Medi-Cal now covering Merck's commercial COVID-19 antiviral Lagevrio
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Coding Corner: How to appropriately apply modifiers LT, RT and 50

December 22, 2023
Area(s) of Interest: Public Health Public Payors 


The California Department of Health Care Services (DHCS) recently announced that Merck’s new commercial Lagevrio (molnupiravir) COVID-19 anti-viral drug is now a covered Medi-Cal Rx benefit.

With the end of the federal public health emergency earlier this  year, COVID-19 drugs are no longer being provided free by the federal government. On November 1, 2023, Lagevrio became available for purchase through commercial channels. Effective November 1, 2023, Medi-Cal Rx will reimburse for the ingredient cost of Lagevrio, in addition to a professional dispensing fee.

Still have federally distributed inventory? Federally distributed inventory should be used until it is depleted or expires, whichever comes first. While Medi-Cal Rx will not reimburse for the ingredient cost of federally distributed Lagevrio, it will still cover the professional dispensing fee.

For more information, click here.

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