Alerts

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

2/8/2023

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 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, October 5, 2022, November 10, 2022, and November 22, 2022.

 

Effective for dates of service on or after December 8, 2022, Medicaid covers the following procedure codes for the administration of the COVID-19 Pfizer vaccine for Medicaid recipients 6 months of age through 4 years of age.

 

Procedure Code

Procedure Code Short Descriptor

Medicaid Rate

0173A

ADM SARSCV2 BVL 3MCG/0.2ML 3

$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 © 2023 American Medical Association and © 2023 American Dental Association (or such other date publication of CPT and CDT). All rights reserved. Applicable FARS/DFARS apply.