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CDC Announces COVID-19 Vaccine Boosters for All, CMS Updates Coding Guidance

For CFOs, billing & coding staff

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The Centers for Disease Control and Prevention (CDC) announced plans to begin offering COVID-19 booster shots to all individuals beginning the week of Sept. 20 and starting eight months after an individual’s second dose, pending authorization from the Food and Drug Administration (FDA) and a review by the CDC’s vaccine advisory committee.

The policy will apply to people over 18 who received the Moderna or Pfizer vaccines. This follows the FDA’s earlier authorization of a third dose of the COVID-19 vaccine for immunocompromised individuals.

Effective Aug. 12, the Centers for Medicare & Medicaid (CMS) will pay to administer additional doses of COVID-19 vaccines consistent with the FDA emergency use authorizations, using CPT code 0003A for the Pfizer vaccine and CPT code 0013A for the Moderna vaccine. CMS will hold and then process all claims with these codes no later than August 27 after the agency completes claims system updates.