Are you planning on administering COVID-19 Vaccines in your office?
NCDHHS has shared the Medicaid and NC Health Choice billing guidance for both the Pfizer-BioNTech and Moderna vaccines in two Special Bulletins (#147 and #148). Please see some of the billing highlights and links to the bulletins below.
Pfizer-BioNTech COVID-19 Vaccine Billing Guidelines
Effective with date of service Dec 12, 2020, the Medicaid and NC Health Choice programs cover Pfizer-BioNTech COVID-19 Vaccine for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code 91300 - Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3mL dosage, diluent reconstituted, for intramuscular use.
COVID-19 Vaccine Billing Codes for Medicaid Beneficiaries
Vaccine CPT Codes to Report
|
Vaccine CPT Code to Report |
NDC |
CPT Code Description |
|
91300 |
59267-1000-01, |
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3mL dosage, diluent reconstituted, for intramuscular use |
Administrative CPT Codes to Bill
|
Administration CPT Code(s) to Bill |
CPT Code Description |
|
0001A |
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3mL dosage, diluent reconstituted; first dose |
|
0002A |
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3mL dosage, diluent reconstituted; second dose |
Moderna COVID-19 Vaccine Billing Guidelines
COVID-19 Vaccine Billing Codes for Medicaid and NC Health Choice Beneficiaries
Administration CPT Codes to Bill
|
Administration CPT Code(s) to Bill |
CPT Code Description |
|
0011A |
Immunization administration by intramuscular injection of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 100 mcg/0.5mL dosage; first dose |
|
0012A |
Immunization administration by intramuscular injection of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 100 mcg/0.5mL dosage; second dose |
Vaccine CPT Code to Report
|
Vaccine CPT Code to Report |
NDC |
CPT Code Description |
|
91301 |
80777-0273-10 |
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 100 mcg/0.5mL dosage, for intramuscular use |
For more detailed billing information check out the link to the Special Bulletins below.
SPECIAL BULLETIN COVID-19 #147: Moderna COVID-19 Vaccine (N/A) HCPCS code 91301: Billing Guidelines
