Novavax COVID-19 Vaccine Update

On August 17, 2022, the Office of MaineCare Services (OMS) released a bulletin regarding the Emergency Use Authorization (EUA) for Novavax COVID-19 vaccine in individuals age 18 and older. 

Effective August 19, 2022, the Food and Drug Administration (FDA) has updated the EUA for the use of the Novavax COVID-19 vaccine for individuals age 12 and older.

Please review the following table for more information about billing codes and payment information.

COVID-19 Novavax COVID-19 Vaccine Codes

Code

Description

Effective Date for Ages 18+

Effective Date for Ages 12-17

MaineCare Rate

91304  

Severe acute respiratory syndrome coronavirus 2 (SARSCoV- 2) (coronavirus disease [COVID-19]) vaccine, recombinant spike protein nanoparticle, saponin-based

07/13/22

08/19/22

$0*

0041A

Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, preservative free, 5 mcg/0.5 mL dosage; first dose

07/13/22

08/19/22

$36.98**

0042A

Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, preservative free, 5 mcg/0.5 mL dosage; second dose

07/13/22

08/19/22

$36.98**

*Government supplied vaccine

**MaineCare Usual, Customary, and Reasonable (UCR) Fee Schedule Rate. Section 45: Hospital Services claims shall be Ambulatory Payment Classification (APC) priced in accordance with CMS status.

Note: The COVID-19 vaccine administration codes have been added for roster billing 

 

If you have questions about Novavax COVID-19 vaccine billing, please contact your Provider Relations Specialist.