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PA Bulletin, Doc. No. 22-869

NOTICES

DEPARTMENT OF HUMAN SERVICES

Updates to Medical Assistance Program Fee Schedule for Administration of the Third Dose of the Pediatric SARS-CoV-2 Vaccine Manufactured by Pfizer, Inc.

[52 Pa.B. 3381]
[Saturday, June 11, 2022]

 In accordance with 55 Pa. Code § 1150.61(a) (relating to guidelines for fee schedule changes), the Department of Human Services (Department) announces the addition of the following procedure code to the Medical Assistance (MA) Program Fee Schedule for the administration of the third dose of the pediatric novel coronavirus (SARS-CoV-2) vaccine manufactured by Pfizer, Inc. The effective date and MA Fee for the code is indicated as follows.

Vaccine
Manufacturer		Procedure
Code		DescriptionEffective Date MA Fee
Pfizer, Inc.0073AImmunization 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, 10 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation; third dose1/3/22$40

 The MA Program Fee Schedule has been updated with the new Current Procedural Terminology (CPT) code for the administration of the third dose of the pediatric SARS-CoV-2 vaccine manufactured by Pfizer, Inc.

 The Department issued an MA Bulletin to enrolled providers to advise them of the addition of the CPT code for the administration of the third dose of the pediatric SARS-CoV-2 vaccine manufactured by Pfizer, Inc. to the MA Program Fee Schedule.

Fiscal Impact

 The estimated fiscal impact of the addition of the CPT code for the administration of the third dose of the pediatric SARS-CoV-2 vaccine manufactured by Pfizer, Inc. for Fiscal Year 2021-2022 is $0.974 million which is 100% Federally funded.

Public Comment

 Interested persons are invited to submit written comments regarding this notice to the Department of Human Services, Office of Medical Assistance Programs, c/o Regulations Coordinator, Room 515, Health and Welfare Building, Harrisburg, PA 17120. Comments received within 30 days will be reviewed and considered for any subsequent revision to the MA Program Fee Schedule.

 Persons with a disability who require an auxiliary aid or service may submit comments using the Pennsylvania Hamilton Relay Service at (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).

MEG SNEAD, 
Acting Secretary

 Fiscal Note: 14-NOT-1515. No fiscal impact; (8) recommends adoption.

[Pa.B. Doc. No. 22-869. Filed for public inspection June 10, 2022, 9:00 a.m.]


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