Update on Covid-19: Vaccinations and CPT Codes

On Tuesday, September 12, the CDC recommended that everyone 6 months and older receive either of the following updated COVID-19 vaccinations:

• Pfizer-BioNTech COVID-19 vaccine (2023-2024 Formula)
• Moderna COVID-19 vaccine (2023-2024 Formula)

See the CDC press release. 

This recommendation follows the FDA's authorization of these products on Monday, September 11.

FDA's authorization simultaneously rescinded the authorization for bivalent vaccines, specifically in this statement: "As part of today's actions, the bivalent Moderna and Pfizer-BioNTech COVID-19 vaccines are no longer authorized for use in the United States."

• Remove all bivalent mRNA COVID-19 vaccines from storage units immediately, even if they are not expired.
• Dispose of all bivalent mRNA COVID-19 vaccine vials in accordance with local, state, and federal regulations.

Source: HRSA Bulletin

From CMS:

Six New CPT Codes Effective September 11, 2023

1. 90480 - COVID-19 Vaccine Administration
2. 91318 - COVID-19 Vaccine, 3 mcg/0.2 mL
3. 91319 - COVID-19 Vaccine, 10 mcg
4. 91320 - COVID-19 Vaccine, 30 mcg
5. 91321 - COVID-19 Vaccine, 25 mcg
6. 91322 - COVID-19 Vaccine, 50 mcg

The federal government isn't purchasing these products.  Medicare Part B pays for the drug and its administration under the applicable Medicare Part B payment policy. Get the most current list of billing codes, including short descriptors, payment allowances, and effective dates.

Medicare no longer pays for these CPT Codes as of September 12, 2023:

91312, 91313, 91314, 91315, 91316, 91317, 0121A, 0124A, 0134A, 0141A, 0142A, 0144A, 0151A, 0154A, 0164A, 0171A, 0172A, 0173A, and 0174A

Source: MLNconnects Newsletter 2023-09-14 OCE