Pfizer-BioNTech COVID-19 Bivalent Vaccine Booster Authorized for Use in Individuals Aged Six Months to Four Years, CR 116564
On March 28, 2023, we sent an announcement that we will cover the Pfizer-BioNTech bivalent COVID-19 vaccine booster for individuals ages six months to four years as outlined in the Emergency Use Authorization (EUA) form the Food and Drug Administration (FDA).
We have completed the update to our systems, and you may begin to submit claims for this service. ***Link to e-message on 3/28 asking them to hold claims.
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Pfizer-BioNTech COVID-19 Bivalent Vaccine Booster - 6 months to 4 years |
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Code |
Description |
Effective Date |
MaineCare Rate |
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0174A |
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, 3 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation, booster dose |
03/14/23 |
$39.11 |
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Note: The COVID-19 vaccine administration codes will be added for roster billing. |
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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.
If you have questions about the use of Monovalent or Bivalent COVID-19 vaccines, please contact your Provider Relations Specialist.
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