• 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

• 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.

 Moderna: https://www.alabamapublichealth.gov/immunization/assets/covid19_moderna_standingorders.pdf

 Pfizer/BioNTech: https://www.alabamapublichealth.gov/immunization/assets/covid19_pfizervaccine_standingorders.pdf