NOTICES

DEPARTMENT OF HUMAN SERVICES

Addition to the Medical Assistance Program Fee Schedule of Additional Bivalent Doses of the SARS-CoV-2 Vaccines Manufactured by Moderna, Inc. and Pfizer, Inc.

[53 Pa.B. 2902]
[Saturday, May 27, 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 additional bivalent doses of the novel coronavirus (SARS-CoV-2) vaccines manufactured by Moderna, Inc. and Pfizer, Inc. The effective date and MA Fee for the codes are indicated as follows.

Vaccine Manufacturer	Procedure Code	Description	Effective Date	MA Fee
Moderna, Inc.	0164A	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, 10 mcg/0.2 mL dosage, booster dose	12/8/22	$40
Pfizer, Inc.	0173A	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, 3 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation, third dose	12/8/22	$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 additional bivalent doses of the SARS-CoV-2 vaccines manufactured by Moderna, Inc. and Pfizer, 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 additional bivalent doses of the SARS-CoV-2 vaccines manufactured by Moderna, Inc. and 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-1577. No fiscal impact; recommends adoption.

[Pa.B. Doc. No. 23-700. Filed for public inspection May 26, 2023, 9:00 a.m.]

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