Alerts

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

11/22/2022

PDF Version 

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, July 26, 2022, August 15, 2022, October 4, 2022, October 5, 2022, and November 10, 2022.

 

Effective for dates of service on or after October 19, 2022, Medicaid covers the following procedure code 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

0044A

ADM SARSCOV2 5MCG/0.5ML BST

$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 © 20
22 American Dental Association (or such other date publication of CPT and CDT). All rights reserved. Applicable FARS/DFARS apply.