UPDATE: Pfizer and Moderna COVID-19 Bivalent Vaccine Authorized for Use in Individuals Aged Six Months to Five Years
On December 16, 2022, the Office of MaineCare Services (OMS) sent an announcement that we will cover the Pfizer BioN-Tech and Moderna bivalent COVID-19 vaccine doses for individuals aged six months to five years as outlined in Emergency Use Authorizations (EUA) from the Food and Drug Administration (FDA)
OMS has completed the update to our systems, and you may begin to submit claims for these services.
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Moderna COVID-19 Bivalent Vaccine Booster- 6 months to 5 years |
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Code |
Description |
Effective Date |
MaineCare Rate |
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91316 |
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, bivalent, preservative free, 10 mcg/0.2 mL dosage, for intramuscular use |
12/08/22 |
$0* |
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0164A |
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, bivalent, preservative free, 10 mcg/0.2 mL dosage, booster dose |
12/08/22 |
$36.98 |
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Pfizer BioN-Tech COVID-19 Bivalent Vaccine Third Dose in Primary Series- 6 months to 4 years |
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Code |
Description |
Effective Date |
MaineCare Rate |
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91317 |
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, for intramuscular use |
12/08/22 |
$0* |
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0173A |
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, third dose |
12/08/22 |
$36.98 |
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*Government Supplied Vaccines
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. The Maine CDC Immunization Program also released this bulletin related to the allowable uses for this age group.
If you have questions about the use of Monovalent or Bivalent COVID-19 vaccines, please contact your Provider Relations Specialist.
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