August 15, 2022

State of Alabama
Press Release: Medicaid

New Coverage for Administration of Novavax COVID-19 Vaccine (for Non-Pharmacy Providers)

PDF Version 


TO: Hospital Providers, Physicians, Nurse Practitioners, Physician Assistants, Dentists, County Health Departments, Federally Qualified Health Centers, and Rural Health Clinics


RE: New Coverage for Administration of Novavax COVID-19 Vaccine (for Non-Pharmacy Providers)


Information in this Provider ALERT is in coordination with the ALERTs published January 11, 2021, March 24, 2021, January 13, 2022, and July 26, 2022.

 

Effective for dates of service on or after July 13, 2022, Medicaid covers the following procedure codes for the administration of the COVID-19 Novavax vaccine for Medicaid recipients 18 years of age or older.

 

Procedure Code

Procedure Code Short Descriptor

Medicaid Rate

0041A

ADM SARSCOV2 5MCG/0.5ML 1ST

$40.00

0042A

ADM SARSCOV2 5MCG/0.5ML 2ND

$40.00

 

Medicaid enrolled providers should not bill for the vaccine if using federally allocated vaccines.

 

To participate in the administration of COVID-19 vaccine, Alabama providers must enroll in the Alabama Department of Public Health’s (ADPH) ImmPRINT COVID-19 Vaccination Program. Follow the steps in the ImmPRINT Registration Roadmap to enroll.

 

Providers must follow state and federal laws and regulations regarding administration of the vaccine, as well as state and federal standing order guidelines for products granted Emergency Use Authorization (EUA).

 

Providers with billing questions should contact the Gainwell Technology Provider Assistance Center at

1-800-688-7989.

 

The Current Procedural Terminology (CPT) and Current Dental Terminology (CDT) codes descriptors, and other data are copyright © 2022 American Medical Association
and © 20
22 American Dental Association (or such other date publication of CPT and CDT). All rights reserved. Applicable FARS/DFARS apply.





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