Wednesday, December 1, 2021
This transmittal provides notice of coverage and reimbursement for fee-for-service providers that bill HCPCS and CPT codes on CMS-1500 claim forms for COVID-19 vaccine administration in the professional fee schedule, and for providers enrolled in Medicaid Managed Care Organization (MCO) networks. This transmittal amends guidance provided in Transmittal # 21-37: Professional Services Billing Codes and Reimbursement Rates for COVID-19 Vaccine issued September 8, 2021, to add the codes and rates for new vaccines or dosages by Pfizer, Janssen, and Moderna for adults as well as codes for the Pfizer COVID-19 vaccine and immunization administration for the pediatric dosage formulation for children ages 5 – 11 years.