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PA Bulletin, Doc. No. 23-802

NOTICES

DEPARTMENT OF HUMAN SERVICES

MA Program Fee Schedule Update for an Additional Bivalent Dose of the SARS-CoV-2 Vaccine Manufactured by Pfizer, Inc.

[53 Pa.B. 3278]
[Saturday, June 17, 2023]

 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 an additional bivalent dose of the 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.0174AImmunization 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,
3 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation; booster dose		3/14/23$40

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

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 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).

VALERIE A. ARKOOSH, 
Acting Secretary

 Fiscal Note: 14-NOT-1582. No fiscal impact; recommends adoption.

[Pa.B. Doc. No. 23-802. Filed for public inspection June 16, 2023, 9:00 a.m.]


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