PDF Version
TO: Physicians, Nurse Practitioners, Physicians
Assistants, FQHCs, RHCs, County Health
Departments, Hospital Providers, and
Dentists
RE: Information on Billing for Administration of COVID-19 Vaccines (for Non-Pharmacy Providers)
Information
in this ALERT is in coordination with the Provider ALERT published December 11,
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.