Alerts

New Coverage for Administration of COVID-19 Vaccine (for Non-Pharmacy Providers)

3/23/2021

PDF Version


TO:  Physicians, Nurse Practitioners, Physician Assistants, FQHCs, RHCs,
County Health Departments, Hospital Providers, and Dentists

 

RE:  New Coverage for Administration of COVID-19 Vaccine (for Non-Pharmacy Providers)

 

Information in this Provider ALERT is in coordination with the ALERTs published December 1, 2020, January 11, 2021, and March 18, 2021.

 

Effective for dates of service on or after February 27, 2021, Medicaid covers the following procedure code for administration of the Janssen COVID-19 vaccine for recipients 18 years of age and older:

 

Administration CPT code

Short description

Medicaid rate

0031A

ADM SARSCOV2 VAC AD26 .5mL

$28.39

 

Effective for dates of service on or after March 15, 2021, and continuing 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, the Medicaid rate for procedure code 0031A is $40.00.

 

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

 

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 the vaccine.

 

State and federal standing order guidelines for products granted Emergency Use Authorization (EUA) must be followed.


·  Janssen Approval for EUA: https://www.fda.gov/media/146303/download


·  COVID-19 Vaccines and Monoclonal Antibodies from CMS:
https://www.cms.gov/medicare/medicare-part-b-drug-average-sales-price/covid-19-vaccines-and-monoclonal-antibodies


·  COVID-19 Vaccination Provider Support:
https://www.alabamapublichealth.gov/immunization/covid-vaccine-administration.html

 

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.