Alerts

Information on Billing for Administration of COVID-19 Vaccines (for Non-Pharmacy Providers)

1/11/2021

PDF Version


TO:  Physicians, Nurse Practitioners, Physicians Assistants, FQHCs, RHCs, County Health

        Departments, Hospital Providers, and Dentists

 

Information in this ALERT is in coordination with the Provider ALERT published December 1, 2020.

 

Effective December 11, 2020, Medicaid covers the following procedure codes for administration of the Pfizer COVID-19 vaccine for recipients 16 years of age and older:

 

Administration CPT code

Short description

Medicaid rate

0001A

1st dose, 30mcg/0.3 mL

$16.94

0002A

2nd dose, 30mcg/0.3 mL

$28.39

 

Effective December 18, 2020, Medicaid covers the following procedure codes for the administration of the Moderna COVID-19 vaccine for recipients 18 years of age and older:

 

Administration CPT code

Short description

Medicaid rate

0011A

1st dose,100mcg/0.5mL

$16.94

0012A

2nd dose,100mcg/0.5 mL

$28.39

 

Medicaid enrolled providers should not bill for the vaccine if using federally allocated vaccines.

 

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.

 

Providers 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:

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

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

 

Providers with billing questions should contact the Gainwell Technology Provider Assistance Center at

1-800-688-7989.



The Current Procedural Terminology (CPT) and Current Dental Terminology (CDT) codes descriptors, and other data are copyright © 2021 American Medical Association and © 2021 American Dental Association (or such other date publication of CPT and CDT). All rights reserved. Applicable FARS/DFARS apply.