Pfizer and Moderna Bivalent COVID-19 Vaccines Authorized to use as Booster Doses
In an August 31, 2022, announcement, the Food and Drug Administration (FDA) issued Emergency Use Authorizations (EUA) for the use of Bivalent COVID-19 Vaccines from Pfizer BioN-Tech and Moderna as a Booster Dose. In response, the American Medical Association (AMA) issued a press release that includes updated Current Procedural Terminology (CPT) codes as shown in the table below.
The Office of MaineCare Services (OMS) will be updating our system to include these codes. We are asking providers to hold all claims for Bivalent COVID-19 Vaccine Booster Doses and their administration until this system update is complete.
Moderna COVID-19 Vaccine Bivalent Booster-18 years and older |
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Code |
Description |
Effective Date |
MaineCare Rate |
|
91313 |
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, bivalent, preservative free, 50 mcg/0.5 mL dosage, for intramuscular use |
08/31/22 |
$0* |
|
0134A |
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, bivalent, preservative free, 50 mcg/0.5 mL dosage, booster dose |
08/31/22 |
TBD** |
Pfizer BioN-Tech COVID-19 Vaccine Bivalent Booster-12 years and older |
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Code |
Description |
Effective Date |
MaineCare Rate |
|
91312 |
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, bivalent spike protein, preservative free, 30 mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular use |
08/31/22 |
$0* |
|
0124A |
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, bivalent spike protein, preservative free, 30 mcg/0.3 mL dosage, tris-sucrose formulation, booster dose |
08/31/22 |
TBD** |
|
*Government Supplied Vaccines **Rates for these codes are not yet established
Note: The COVID-19 vaccine administration codes will be added for roster billing |
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This authorization replaces the prior EUAs for the Monovalent COVID-19 Vaccine Booster Dose from these suppliers for individuals age 12 and up.
No Longer Authorized-Pfizer BioN-Tech COVID-19 Vaccine Booster-12 years and older |
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Code |
Description |
Effective Date |
End Date |
|
91300 |
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3mL dosage, diluent reconstituted, for intramuscular use |
12/11/2020 |
08/31/22* |
|
0004A |
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3 mL dosage, diluent reconstituted; booster dose |
9/22/2021 |
08/31/22 |
|
91305 |
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3 mL dosage, trissucrose formulation, for intramuscular use |
1/3/2022 |
08/31/22* |
|
0054A |
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3 mL dosage, tris-sucrose formulation; booster dose |
1/3/2022 |
08/31/22 |
No Longer Authorized-Moderna COVID-19 Vaccine Booster-18 years and older |
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|
91306 |
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 50 mcg/0.25 mL dosage, for intramuscular use |
10/21/2021 |
08/31/22* |
|
0064A |
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 50 mcg/0.25 mL dosage, booster dose |
10/20/2021 |
08/31/22 |
|
0094A |
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 50 mcg/0.5 mL dosage, booster dose |
3/29/2022 |
08/31/22 |
|
*Drug is only authorized for use with a Primary Dose Covid Vaccine Series. Do not use this drug code when billing booster doses for the age ranges specified. |
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Providers may visit the Maine CDC Immunization Program Website for up to date information on administering and ordering COVID-19 Vaccine and Booster Doses. The Maine CDC also issued this notice that includes information on COVID-19 Vaccine Booster Doses.
If you have questions about the use of Monovalent or Bivalent COVID-19 Vaccine Booster Doses, please contact your Provider Relations Specialist.
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