Alerts

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

7/26/2022



TO: Hospital Providers, Physicians, Nurse Practitioners, Physician Assistants, Dentists, County Health Departments, Federally Qualified Health Centers, and Rural Health Clinics

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 January 11, 2021, March 24, 2021, and January 13, 2022.

Effective for dates of service on or after dates listed in chart, Medicaid covers the following procedure codes for the administration of the COVID-19 Pfizer vaccine for Medicaid recipients 5 years of age through 11 years of age.

Procedure Code Procedure Code Short Descriptor Effective Dates Medicaid Rate
0073A ADM SARSCV2 10MCG TRS-SUCR 3 01/03/2022 $40.00
0074A ADM SARSCV2 10MCG TRS-SUCR B 05/17/2022 $40.00

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 (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, as well as state and federal standing order guidelines for products granted Emergency Use Authorization (EUA). 

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 © 2022 American Medical Association and © 2022 American Dental Association (or such other date publication of CPT and CDT). All rights reserved. Applicable FARS/DFARS apply.