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PA Bulletin, Doc. No. 22-1549

NOTICES

DEPARTMENT OF HUMAN SERVICES

Updates to the Medical Assistance Program Fee Schedule for Administration of SARS-CoV-2 Vaccine Manufactured by Novavax

[52 Pa.B. 6435]
[Saturday, October 8, 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 codes to the Medical Assistance (MA) Program Fee Schedule for the administration of the SARS-CoV-2 vaccine manufactured by Novavax. The effective date and MA fee for each code is indicated as follows.

Procedure
Code
DescriptionEffective
Date
MA
Fee
0041AImmunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease (COVID-19)) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, preservative free, 5 mcg/0.5mL dosage; first dose7/13/22$40
0042AImmunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease (COVID-19)) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, preservative free, 5 mcg/0.5mL dosage; second dose7/13/22$40

 The MA Program Fee Schedule has been updated with the new Current Procedural Terminology (CPT) codes to allow for payment of the administration of the SARS-CoV-2 vaccines manufactured by Novavax.

 The Department issued an MA Bulletin to inform providers enrolled in the MA Program of the addition of the CPT codes for the administration of SARS-CoV-2 vaccines manufactured by Novavax.

Fiscal Impact

 There is no fiscal impact associated with the addition of these procedure codes.

Public Comment

 Interested persons are invited to submit written comments to the Department of Human Services, Office of Medical Assistance Programs, c/o Regulations Coordinator, P.O. Box 2675, Harrisburg, PA 17120, RA-PWMAProgComments@ pa.gov. Comments received within 30 days will be reviewed and considered for any subsequent revision of the notice.

 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-1537. No fiscal impact; (8) recommends adoption.

[Pa.B. Doc. No. 22-1549. Filed for public inspection October 7, 2022, 9:00 a.m.]



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