Client Alert: COVID-19 Vaccine Billing Codes Released

This week, the American Medical Association (AMA)’s CPT Editorial Panel, in collaboration with CMS and the CDC, released new CPT codes in advance of the anticipated release of two immunizations for the disease caused by the novel coronavirus (SARS-CoV-2, also known as COVID-19) projected as early as the next few months. AMA created two new CPT codes for two different vaccines as well as two sets of unique administration codes—one for each vaccine. This release is being offered in advance to allow health care providers to update their billing and medical record systems before the vaccine is publicly available. The AMA announced that these codes would be available for use once each vaccine receives Emergency Use Authorization or other approval from the Food and Drug Administration.

The two vaccine manufacturers are Pfizer and Moderna. These vaccines may require two doses. NDC and VAC codes needed for billing are provided as well on the AMA’s website. AMA has released separate and unique administration codes, not only for each vaccine, but also for each dose of the vaccine for tracking, reporting, and analysis purposes. Thus, there are four administration codes in total.

The new vaccine codes are:

• 91300 (Pfizer): Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3mL dosage, diluent reconstituted, for intramuscular use
• 91301 (Moderna): Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 100 mcg/0.5mL dosage, for intramuscular use

• (For 91300) 0001A: Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3mL dosage, diluent reconstituted; first dose
• (For 91300) 0002A: Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3mL dosage, diluent reconstituted; second dose
• (For 91301) 0011A: Immunization administration by intramuscular injection of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 100 mcg/0.5mL dosage; first dose
• (For 91301) 0012A: Immunization administration by intramuscular injection of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 100 mcg/0.5mL dosage; second dose

If your practice intends on providing these vaccines, you may consider working with your billing and IT staff to plan for the addition of these codes to your respective billing and Electronic Medical Records (EMR) platforms. Additionally, you may consider any necessary EMR templates and other internal training and documentation, including the latest Vaccine Information Statement (VIS) associated with this type of vaccine.