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