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The current procedural terminology (CPT) code has been published by an AMA update which includes new vaccine-specific codes to report immunizations for the new coronavirus, SARS-CoV-2, that are unique to the COVID-19 vaccine under development by Janssen Pharmaceutical, a division of Johnson & Johnson. 

There are two coronavirus vaccine CPT Codes approved by the American Medical Association, 91300 and 91301. These two codes are used to better track, report, and analyze data for coronavirus vaccine planning and distribution. They are made by Pfizer and Moderna and both require two doses.

The CPT Editorial panel has worked closely with the centers for Disease Control and Prevention and approved a unique CPT code for each of four coronavirus vaccines- others from Pfizer-BioNTech and Moderna that have been authorized in the U. S together with the vaccine candidates made by Johnson & Johnson and AstraZeneca- also administration codes are unique to such vaccine. 

Four vaccine administration codes have also been added: 0001A, 0002A, 0011A, and 0012A. These administration codes are specific to each of the two vaccines, and whether it is the first or second dose given to the patient.

Here we show category I CPT codes and long descriptors for the vaccine products;

CPT Codes for Corona Vaccine

• 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 dosages, diluent reconstituted, for intramuscular use.
• 91301: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative-free, 100 mcg/0.5mL dosages, for intramuscular use.
• 91302: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, DNA, spike protein, chimpanzee adenovirus Oxford 1 (ChAdOx1) vector, preservative-free, 5×1010 viral particles/0.5mL dosage, for intramuscular use.
• 91303: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, DNA, spike protein, adenovirus type 26 (Ad26) vector, preservative-free, 5×1010 viral particles/0.5mL dosage, for intramuscular use.

COVID-19 Vaccine Administration Codes 

The COVID-19 vaccine administration codes are specific to the coronavirus vaccine and dosage. These are responsible to report the work of administering the vaccine, counseling the patient or caregiver, and documenting the medical record. 

0001A

The 0001A COVID-19 vaccine administration CPT code is for the first dose of the Pfizer vaccine only. Administration of immunization by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease vaccine, mRNA-LNP, spike protein, preservative-free, 30 mcg/0.3mL dosages, diluent reconstituted; first dose. 

0002A

The 0002A COVID-19 vaccine administration CPT code is for the second dose of the Pfizer vaccine only. Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease vaccine, mRNA-LNP, spike protein, preservative-free, 30 mcg/0.3mL dosages, diluent reconstituted; second dose.

0011A

The 0011A COVID-19 vaccine administration CPT code is for the first dose of the Moderna vaccine only. Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease vaccine, mRNA-LNP, spike protein, preservative-free, 100 mcg/0.5mL dosages; first dose.

0012A

The 0012A COVID-19 vaccine administration CPT code is for the second dose of the Moderna vaccine only. Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease vaccine, mRNA-LNP, spike protein, preservative-free, 100 mcg/0.5mL dosages; second dose.

How To Bill For The COVID-19 Vaccine?

Just like billing of various specialties, proper medical billing for the Coronavirus vaccine also important for reimbursements and governmental reporting purposes. 

Every coronavirus vaccine has its own specific CPT code based on the vaccine manufacturer (Pfizer or Moderna). Moreover, the vaccine administration code highly depends on the manufacturer plus the number of doses. 

It is important to note that when you are submitting claims only vaccine administration codes are bill. You can’t include the vaccine CPT codes when the coronavirus vaccines are free. 

Thinking about how you can bill for the Pfizer COVID-19 vaccine? Here is an example 

For Pfizer First Dose:

To bill COVID-19 Vaccine first dose that is 91300 (Vaccine CPT), administrative 0001A, and ICD-10: Z23 is used.

For Pfizer 2nd Dose:

To bill COVID-19 Vaccine first dose that is 91300 (Vaccine CPT), administrative 0002A, and ICD-10: Z23 is used (only administrative code is changed).

For Moderna First Dose:

To bill Moderna first dose vaccine CPT: 91301, Administration: 0011A, and ICD-10: Z23 are used.

For Moderna 2nd Dose:

To bill Moderna first dose vaccine CPT: 91301, Administration: 0012A, and ICD-10: Z23 are used.

How will the COVID-19 vaccine be reimbursed?

The Coronavirus vaccine is provided by the Federal Government when it first comes out. As a result, there will be no reimbursement for the vaccines themselves. However, CMS has proposed reimbursement rates; for the first dose: $16.94 and $28.39 is for 2nd dose.

Need more updates about COVID-19 reimbursement? Then call our experts at +1 888-598-9181.