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

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

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

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

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

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.

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.