COVID-19 Vaccine Information for Pharmacy Billing


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TO:     All Pharmacy Providers


RE:     COVID-19 Vaccine Information for Pharmacy Billing


Alabama Medicaid will allow reimbursement to pharmacies for a vaccine administration fee to Medicaid providers who utilize federally allocated COVID-19 vaccines. For claims effective March 15, 2021 and after, the reimbursement rate for the administration fee is $40.00 per dose, and will continue only during that time as described by the American Rescue Plan Act of 2021 that provides for increased FMAP for administration of the COVID-19 Vaccine unless ended sooner by the Alabama Medicaid Agency in a subsequent Alert.

·         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. 

o  Submit each vaccine with the specific approved vaccine NDC for an eligible recipient.

o  Submit the administration fee in the Incentive Amount Submitted field (NCPDP Field 438-E3) on the same claim as the vaccine (i.e. ingredient).

o  For claims on/after March 15, 2021, the administration fee is $40.00 per dose.

o  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 (440-E5)

Incentive Amount (Administration Fee 438-E3)

Ingredient Cost


Two Dose Vaccines

First Dose

Not needed / blank


$0.00 or $0.01

Second Dose

Not needed / blank


$0.00 or $0.01

Single-Dose Vaccines

Single Dose

Not needed / blank


$0.00 or $0.01



·   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.

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