NOTICES
DEPARTMENT OF HUMAN SERVICES
Addition of Bivalent Booster Dose of the SARS-CoV-2 Vaccines Manufactured by Pfizer, Inc. and Moderna, Inc.
[53 Pa.B. 1020]
[Saturday, February 18, 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 codes to the Medical Assistance (MA) Program Fee Schedule for the administration of the bivalent booster dose of the novel coronavirus (SARS-CoV-2) vaccines manufactured by Pfizer, Inc. and Moderna, Inc. The effective date and MA Fee for the codes are indicated as follows.
Vaccine Manufacturer Procedure Code Description Effective Date MA Fee Pfizer, Inc. 0124A 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 8/31/22 $40 Moderna, Inc. 0134A 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 8/31/22 $40 0144A 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, 25 mcg/0.25 mL dosage, booster dose 10/12/22 $40 Pfizer, Inc. 0154A 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, 10 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation, booster dose 10/12/22 $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 bivalent booster dose of the SARS-CoV-2 vaccines manufactured by Pfizer, Inc. and Moderna, Inc.
The Department issued an MA Bulletin to enrolled providers to advise them of the addition of the CPT codes for the administration of the bivalent booster dose of the SARS-CoV-2 vaccines manufactured by Pfizer, Inc. and Moderna, 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 SecretaryFiscal Note: 14-NOT-1562. No fiscal impact; (8) recommends adoption.
[Pa.B. Doc. No. 23-228. Filed for public inspection February 17, 2023, 9:00 a.m.]
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