Scribd
Upload
62 views2 pages

COVID Vaccine Codes

The document lists CPT and HCPCS codes for COVID-19 vaccines and their administrations for different manufacturers, including AstraZeneca, Janssen, Moderna, Novavax, and Pfizer. It also provides the national payment allowance amounts for COVID-19 vaccines and their administrations effective March 15, 2021, ranging from $0.01 for vaccines to $40 for administrations. Finally, it includes a code and payment for COVID-19 vaccine administration inside a patient's home.

Uploaded by

Vinay Kumar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
62 views2 pages

COVID Vaccine Codes

The document lists CPT and HCPCS codes for COVID-19 vaccines and their administrations for different manufacturers, including AstraZeneca, Janssen, Moderna, Novavax, and Pfizer. It also provides the national payment allowance amounts for COVID-19 vaccines and their administrations effective March 15, 2021, ranging from $0.01 for vaccines to $40 for administrations. Finally, it includes a code and payment for COVID-19 vaccine administration inside a patient's home.

Uploaded by

Vinay Kumar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
You are on page 1/ 2

CPT Code or Labeler

CPT or HCPCS Short Descriptor Code Type


HCPCS Code Name

91302 SARSCOV2 VAC 5X10^10VP/.5MLIM AstraZeneca Product


0021A ADM SARSCOV2 5X10^10VP/.5ML 1 AstraZeneca Administration
0022A ADM SARSCOV2 5X10^10VP/.5ML 2 AstraZeneca Administration
91303 SARSCOV2 VAC AD26 .5ML IM Janssen Product
0031A ADM SARSCOV2 VAC AD26 .5ML Janssen Administration
0034A ADM SARSCOV2 VAC AD26 .5ML B Janssen Administration
91301 SARSCOV2 VAC 100MCG/0.5ML IM Moderna Product
0011A ADM SARSCOV2 100MCG/0.5ML1ST Moderna Administration
0012A ADM SARSCOV2 100MCG/0.5ML2ND Moderna Administration
0013A ADM SARSCOV2 100MCG/0.5ML3RD Moderna Administration
91306 SARSCOV2 VAC 50MCG/0.25ML IM Moderna Product
0064A ADM SARSCOV2 50MCG/0.25MLBST Moderna Administration
91304 SARSCOV2 VAC 5MCG/0.5ML IM Novavax Product
0041A ADM SARSCOV2 5MCG/0.5ML 1ST Novavax Administration
0042A ADM SARSCOV2 5MCG/0.5ML 2ND Novavax Administration
91300 SARSCOV2 VAC 30MCG/0.3ML IM Pfizer Product

0001A ADM SARSCOV2 30MCG/0.3ML 1ST Pfizer Administration

0002A ADM SARSCOV2 30MCG/0.3ML 2ND Pfizer Administration

0003A ADM SARSCOV2 30MCG/0.3ML 3RD Pfizer Administration

0004A ADM SARSCOV2 30MCG/0.3ML BST Pfizer Administration

91305 SARSCOV2 VAC 30 MCG TRS-SUCR Pfizer Product

0051A ADM SARSCV2 30MCG TRS-SUCR 1 Pfizer Administration

0052A ADM SARSCV2 30MCG TRS-SUCR 2 Pfizer Administration

0053A ADM SARSCV2 30MCG TRS-SUCR 3 Pfizer Administration

0054A ADM SARSCV2 30MCG TRS-SUCR B Pfizer Administration


91307 SARSCOV2 VAC 10 MCG TRS-SUCR Pfizer Product
0071A ADM SARSCV2 10MCG TRS-SUCR 1 Pfizer Administration

0072A ADM SARSCV2 10MCG TRS-SUCR 2 Pfizer Administration

0073A ADM SARSCV2 10MCG TRS-SUCR 3 Pfizer Administration

Home vaccine
M0201 Covid-19 vaccine home admin Administration
admin
National Payment
Allowance Effective for
Vaccine/Procedure Name
Claims with DOS on or
after 03/15/2021
AstraZeneca Covid-19 Vaccine $0.010
AstraZeneca Covid-19 Vaccine Administration – First Dose $40.00
AstraZeneca Covid-19 Vaccine Administration – Second Dose $40.00
Janssen Covid-19 Vaccine[3]*** $0.010
Janssen Covid-19 Vaccine Administration - First Dose[3]*** $40.00
Janssen Covid-19 Vaccine Administration -  Booster ***
[3]
$40.00
Moderna Covid-19 Vaccine $0.01
Moderna Covid-19 Vaccine Administration – First Dose $40.00
Moderna Covid-19 Vaccine Administration – Second Dose $40.00
Moderna Covid-19 Vaccine Administration – Third Dose $40.00
Moderna Covid-19 Vaccine (Low Dose) $0.010
Moderna Covid-19 Vaccine (Low Dose) Administration - Booster $40.00
Novavax Covid-19 Vaccine $0.010
Novavax Covid-19 Vaccine Administration – First Dose $40.00
Novavax Covid-19 Vaccine Administration – Second Dose $40.00
Pfizer-BioNTech Covid-19 Vaccine (Purple Cap) $0.01
Pfizer-BioNTech Covid-19 Vaccine (Purple Cap) Administration – First
$40.00
Dose
Pfizer-BioNTech Covid-19 Vaccine (Purple Cap) Administration –
$40.00
Second Dose
Pfizer-BioNTech Covid-19 Vaccine (Purple Cap) Administration –
$40.00
Third Dose
Pfizer-BioNTech Covid-19 Vaccine (Purple Cap) Administration –
$40.00
Booster
Pfizer-BioNTech Covid-19 Vaccine Pre-Diluted (Gray Cap) $0.010
Pfizer-BioNTech Covid-19 Vaccine Pre-Diluted (Gray Cap)
$40.00
Administration - First dose
Pfizer-BioNTech Covid-19 Vaccine Pre-Diluted (Gray Cap)
$40.00
Administration - Second dose
Pfizer-BioNTech Covid-19 Vaccine Pre-Diluted (Gray Cap)
$40.00
Administration - Third dose
Pfizer-BioNTech Covid-19 Vaccine Pre-Diluted (Gray Cap)
$40.00
Administration - Booster
Pfizer-BioNTech Covid-19 Pediatric Vaccine (Orange Cap) $0.010
Pfizer-BioNTech Covid-19 Pediatric Vaccine (Orange Cap) - $40.00
Administration - First dose
Pfizer-BioNTech Covid-19 Pediatric Vaccine (Orange Cap) - $40.00
Administration - Second dose
Pfizer-BioNTech Covid-19 Pediatric Vaccine (Orange Cap) - $40.00
Administration - Third dose
Covid-19 vaccine administration inside a patient's home; reported only
once per individual home per date of service when only covid-19 $35.50
vaccine administration is performed at the patient's home

You might also like