October 4, 2023

State of Alabama
Press Release: Medicaid

New Coverage for 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 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, July 26, 2022, August 15, 2022, October 4, 2022, October 5, 2022, November 10, 2022, November 22, 2022, February 8, 2023, April 20, 2023, and June 26, 2023.

 

Effective for dates of service on or after September 11, 2023, Medicaid covers the following new procedure codes for COVID-19 vaccines.

 

Procedure Code

Procedure Code Short Descriptor

Age Restriction

Medicaid Rate

90480

ADMN SARSCOV2 VACC 1 DOSE

6m - older

$40.00

91318

SARSCOV2 VAC 3MCG TRS-SUC

6m - older

$65.36

91319

SARSCOV2 VAC 10MCG TRS-SUC IM

6m - older

$87.78

91320

SARSCOV2 VAC 30MCG TRS-SUC IM

6m - older

$131.10

91321

SARSCOV2 VAC 25MCG/0.25ML IM

6m - older

$145.92

91322

SARSCOV2 VAC 50MCG/0.5ML IM

6m - older

$145.92

 

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 (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 Technologies 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 © 2023 American Medical Association and © 2023 American Dental Association (or such other date publication of CPT and CDT). All rights reserved. Applicable FARS/DFARS apply.

 



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