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The Centers for Medicare & Medicaid Services (CMS) has announced that both insured and uninsured people can get COVID-19 vaccines, including the new bivalent Moderna or Pfizer-BioNTech COVID-19 booster, at no cost, for as long as the federal government continues purchasing and distributing them.
The Food & Drug Administration authorized the Moderna and Pfizer-BioNTech updated vaccines that target the original COVID-19 viral strain and two omicron variants (BA.4/BA.5). Individuals are eligible for their updated vaccine shot at least two months after completing at least their primary vaccination series (two doses of Pfizer-BioNTech, Moderna, or Novavax, or one dose of Johnson & Johnson) — regardless of how many monovalent COVID-19 boosters they have received to date.
CMS issued four new Current Procedural Terminology codes for reporting COVID-19 immunizations, effective Aug. 31:
- Code 91312 for Pfizer-BioNTech COVID-19 Vaccine, Bivalent Product:
- Long descriptor: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, bivalent spike protein, preservative free, 30 mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular use
- Short descriptor: SARSCOV2 VAC BVL 30MCG/0.3ML
- Code 91313 for Moderna COVID-19 Vaccine, Bivalent Product:
- Long descriptor: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, bivalent, preservative free, 50 mcg/0.5 mL dosage, for intramuscular use
- Short descriptor: SARSCOV2 VAC BVL 50MCG/0.5ML
- Code 0124A for Pfizer-BioNTech COVID-19 Vaccine, Bivalent – Administration – Booster Dose:
- Long descriptor: Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, bivalent spike protein, preservative free, 30 mcg/0.3 mL dosage, tris-sucrose formulation, booster dose
- Short descriptor: ADM SARSCV2 BVL 30MCG/.3ML B
- Code 0134A for Moderna COVID-19 Vaccine, Bivalent – Administration – Booster Dose:
- Long descriptor: Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, bivalent, preservative free, 50 mcg/0.5 mL dosage, booster dose
- Short descriptor: ADM SARSCV2 BVL 50MCG/.5ML B
Additional details are available in the COVID-19 Vaccine Provider Toolkit, including the most current list of billing codes, payment allowances, and effective dates.
