March 18, 2021

State of Alabama
Press Release: Medicaid

Reimbursement Increase for COVID-19 Vaccine Administration

PDF Version 

TO:     Physicians, Nurse Practitioners, Physician Assistants, FQHCs, RHCs, County Health Departments, Long Term Care Providers, Hospital Providers, and Dentists

 

RE:     Reimbursement Increase for COVID-19 Vaccine Administration

 

Information in this ALERT is in coordination with the Provider ALERT published December 1, 2020, December 29, 2020, and January 11, 2021.

 

Effective March 15, 2021, and continuing only during that time as described by the American Rescue Plan Act of 2021 that provides for increased FMAP for administration of the COVID-19 Vaccine, unless ended sooner by the Alabama Medicaid Agency in a subsequent ALERT, Medicaid will increase reimbursement for the following procedure codes for administration of the Pfizer COVID-19 vaccine for recipients 16 years of age and older:

 

Administration CPT code

Short description

Medicaid rate

0001A

1st dose, 30mcg/0.3 mL

$40

0002A

2nd dose, 30mcg/0.3 mL

$40

 

Effective March 15, 2021, and continuing only during that time as described by the American Rescue Plan Act of 2021 that provides for increased FMAP for administration of the COVID-19 Vaccine, unless ended sooner by the Alabama Medicaid Agency in a subsequent ALERT, Medicaid will increase reimbursement for the following procedure codes for the administration of the Moderna COVID-19 vaccine for recipients 18 years of age and older:

 

Administration CPT code

Short description

Medicaid rate

0011A

1st dose-100mcg/0.5mL

$40

0012A

2nd dose-100mcg/0.5 mL

$40

 

Providers may resubmit claims for date of service on or after March 15, 2021 which were reimbursed at the lower rate. Medicaid enrolled providers should not bill for the vaccine if using federally allocated vaccines. Providers must follow state and federal laws and regulations regarding administration of vaccines. Providers with billing questions should contact the Gainwell Technology Provider Assistance Center at 1-800-688-7989.

 

To receive, administer, and report COVID-19 vaccines, healthcare providers must enroll in the ADPH’s ImmPRINT COVID-19 Vaccination Program. Follow the steps in the ImmPRINT Registration Roadmap to enroll.

 

Resources for providers related to COVID-19 vaccines:

·                  COVID-19 Vaccination Provider Support

·                  CDC Clinical Resources for COVID-19 Vaccine

·                  CDC COVID-19 Vaccination Recommendations

For provider information regarding COVID-19 vaccinations from Alabama Medicaid, please visit:  https://medicaid.alabama.gov/content/7.0_Providers/7.11_COVID-19_Vaccine_Providers.aspx.




  • For more information, visit http://medicaid.alabama.gov
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