State of Alabama

11/10/2022 | Press release | Distributed by Public on 11/10/2022 14:40

New Coverage for Administration of Pfizer COVID-19 Vaccine (for Non-Pharmacy Providers)

PDF Version

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 (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, and October 5, 2022.

Effective for dates of service on or after October 12, 2022, Medicaid covers the following procedure codes for the administration of the COVID-19 Pfizer vaccine for Medicaid recipients 5 years of age through 11 years of age.

Procedure Code

Procedure Code Short Descriptor

Medicaid Rate

0154A

ADM SARSCV2 BVL 10MCG/.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 Technology 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 © 2022 American Medical Association and © 2022 American Dental Association (or such other date publication of CPT and CDT). All rights reserved. Applicable FARS/DFARS apply.