DHHS → Office of MaineCare Services (OMS) → Provider Resources → UPDATE: Pfizer and Moderna COVID-19 Bivalent Vaccine Authorized for Use in Individuals Aged Six Months to Five Years

UPDATE: Pfizer and Moderna COVID-19 Bivalent Vaccine Authorized for Use in Individuals Aged Six Months to Five Years

Dec 29, 2022

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.

Moderna COVID-19 Bivalent Vaccine Booster- 6 months to 5 years
Code	Description	Effective Date	MaineCare Rate
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*
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
Pfizer BioN-Tech COVID-19 Bivalent Vaccine Third Dose in Primary Series- 6 months to 4 years
Code	Description	Effective Date	MaineCare Rate
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*
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
*Government Supplied Vaccines Note: The COVID-19 vaccine administration codes will be added for roster billing

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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