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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 Booster
(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, November 22, 2022, and February 8,
2023.
Effective for
dates of service on or after March 14, 2023, Medicaid covers the following procedure
codes for the administration of the COVID-19 Pfizer vaccine booster for Medicaid
recipients 6 months of age through 4 years of age.
Procedure Code
|
Procedure Code Short Descriptor
|
Medicaid Rate
|
0174A
|
ADM
SARSCV2 BVL 3MCG/0.2ML 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 Technologies 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.