COVID-19 Vaccine Additional Dose - Payment
Medicare stands ready to pay for administering an additional dose of COVID-19 vaccine consistent with the FDA emergency use authorization (EUA).
They will pay the same amount to administer this additional dose as we did for other doses of the COVID-19 vaccine (approximately $40 each).
The U.S. Food and Drug Administration amended the emergency use authorizations (EUAs) for both the Pfizer-BioNTech COVID-19 Vaccine and the Moderna COVID-19 Vaccine to allow for the use of an additional dose in certain immunocompromised individuals, specifically, solid organ transplant recipients or those who are diagnosed with conditions that are considered to have an equivalent level of immunocompromise.
Additional New CPT codes - COVID-19 Vaccine - Effective from 08/12/2021
When COVID-19 vaccine and monoclonal antibody doses are provided by the government without charge, only bill for the vaccine administration. Don't include the vaccine codes on the claim when the vaccines are free.
If the patient is enrolled in a Medicare Advantage (MA) plan, submit your COVID-19 vaccine and monoclonal antibody infusion claims to Original Medicare in 2020 and 2021.
The specified below codes are effective date from August 12th, 2021.
ADM SARSCOV2 30MCG/0.3ML3RD
Pfizer-Biontech COVID-19 Vaccine Administration – Third Dose
ADM SARSCOV2 100MCG/0.5ML3RD
Moderna COVID-19 Vaccine Administration – Third Dose