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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 Pfizer 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, July 26, 2022, August 15, 2022, October 4,
2022, and October 5, 2022.
Effective for
dates of service on or after October 12, 2022, 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
|
Medicaid
Rate
|
0154A
|
ADM SARSCV2
BVL 10MCG/.2ML B
|
$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.