MLN Connects 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
CDC COVID-19 Vaccination Communication Toolkit for medical centers, clinics, and clinicians
FDA COVID-19 Vaccines webpage

Last Updated: 12/14/2020