COVID-19 Vaccine Information for Pharmacy Billing


TO:    All Pharmacy Providers


RE:   COVID-19 Vaccine Information for Pharmacy Billing



Alabama Medicaid will allow vaccine administration fee reimbursement to Medicaid participating providers for federally-allocated COVID-19 vaccines.


  • Pharmacies will bill vaccines through an electronic NCPDP claim.

o Submit $0.00 or $0.01 for vaccine provided at no cost from the federal government. 

    • Submit each vaccine with the specific approved vaccine NDC for an eligible recipient.
    • Submit the administration fee in the Incentive Amount Submitted field (NCPDP Field 438-E3) on the same claim as the vaccine (i.e., ingredient).
    • Medicaid will allow for vaccine/administration with an effective date on/after 12/28/2020.
    • Vaccines must be administered according to approved labeling for appropriate ages and dosing interval.


       NCPDP Codes and Allowed Amounts for COVID-19 Vaccine Administration

Submission Clarification Code


Incentive Amount (Administration Fee 438-E3)

Ingredient Cost


Two-Dose Vaccines

First Dose



$0.00 or $0.01

Second Dose



$0.00 or $0.01

Single-Dose Vaccines

Single Dose



$0.00 or $0.01



  • The payment rate for COVID-19 vaccine administration is $28.39 to administer single-dose vaccines.
    • For single-dose vaccine claims, the Submission Clarification Code (SCC) should remain blank.
  • The payment rate for a COVID-19 vaccine administration requiring a series of two or more doses is $16.94 for the initial dose, and $28.39 for the administration of the final dose in the series.
    • For multi-dose vaccines, submit 02 (other override) for the initial dose in the SCC field.
    • For the second dose, submit 06 (the previous medication was a starter dose and now additional medication is needed to continue treatment) in the SCC field.
  • To participate in the administration of COVID-19 vaccine, Alabama providers must enroll in the Alabama Department of Public Health’s (ADPH) ImmPRINT COVID-19 Vaccination Program. Follow the steps in the ImmPRINT Registration Roadmap to enroll. 
  • Pharmacies must follow state and federal laws and regulations regarding administration of vaccines.
  • State and federal standing order guidelines for products granted Emergency Use Authorization (EUA) must be followed. Standing order guidelines can be found at the links below.




Pharmacy providers with questions regarding vaccine administration may call the Alabama Medicaid Pharmacy Program at (334) 242-5050.