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 Novavax 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, January 13, 2022, and July 26, 2022.
Effective for
dates of service on or after July 13, 2022, Medicaid covers the following procedure
codes for the administration of the COVID-19 Novavax vaccine for Medicaid recipients
18 years of age or older.
Procedure
Code
|
Procedure Code Short Descriptor
|
Medicaid
Rate
|
0041A
|
ADM SARSCOV2 5MCG/0.5ML
1ST
|
$40.00
|
0042A
|
ADM SARSCOV2 5MCG/0.5ML
2ND
|
$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’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, 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.