COVID-19 Vaccine Codes: Updated Effective Date for Pfizer-BioNTech

CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS) Special Edition – Monday, December 14, 2020

 

COVID-19 Vaccine Codes: Updated Effective Date for Pfizer-BioNTech On December 11, 2020, the U.S. Food and Drug Administration issued an Emergency Use Authorization (EUA) for the Pfizer-BioNTech COVID‑19 Vaccine for the prevention of COVID-19 for individuals 16 years of age and older. Review Pfizer’s Fact Sheet for Healthcare Providers Administering Vaccine (Vaccination Providers) regarding the limitations of authorized use. During the COVID-19 Public Health Emergency (PHE), Medicare will cover and pay for the administration of the vaccine (when furnished consistent with the EUA). Review our updated payment and HCPCS Level I CPT code structure for specific COVID-19 vaccine information. Only bill for the vaccine administration codes when you submit claims to Medicare; don’t include the vaccine product codes when vaccines are free. Related links: CMS COVID-19 Provider Toolkit CMS COVID-19 FAQs CDC COVID-19 Vaccination Communication Toolkit for medical centers, clinics, and clinicians FDA COVID-19 Vaccines webpage Like our newsletter? Have suggestions? Please let us know! The Medicare Learning Network®, MLN Connects®, and MLN Matters® are registered trademarks of the U.S. Department of Health and Human Services (HHS).