​​COVID-19 Vaccine Updates for Fall 2023​

fb88Care will continue to provide full coverage, without cost sharing through September 30, 2024, for the COVID-19 vaccine and its administration as required by the American Rescue Plan Act (ARPA) of 2021. The ARPA requirement applies only to those persons with current fb88Care coverage. Anyone who is uninsured or who does not have full fb88Care coverage may have access to the vaccine through the Center for Disease Controls (CDC) .  

On September 11, 2023, the Food and Drug Administration (FDA) and authorized for emergency use updated COVID-19 vaccine formulas. As a result of this action, ALL previously authorized COVID-19 vaccines and vaccine boosters are no longer authorized. This includes both the monovalent, bivalent, and booster doses from Pfizer BioN-Tech and Moderna. The COVID-19 vaccine produced by Novavax will still be authorized for use and reimbursement. 

On August 14, 2023, the American Medical Association (AMA) a special edition of the CPT Assistant which provides new codes for the Food and Drug Administration’s (FDA) recommended COVID-19 vaccines for Fall of 2023. The streamlined billing structure now has just six (6) codes for the COVID-19 vaccine doses and one (1) code for the COVID-19 vaccine administration. Please note, the vaccine administration codes specific to the Novavax vaccine are no longer available for use, the one (1) new administration code will be used for vaccine administration for all manufacturers.  

The Office of fb88Care (OMS) will be updating our systems to reflect the changes listed in the table below. OMS is asking that providers please hold COVID-19 vaccine claims until the system update is complete. Please watch for a future notice announcing the system update.  

 

New COVID- 19 Billing Codes  

Pfizer BioN-Tech COVID-19 Vaccine – 6 months through 4 years old 

°ä´Ç»å±ð &²Ô²ú²õ±è;

¶Ù±ð²õ³¦°ù¾±±è³Ù¾±´Ç²Ô &²Ô²ú²õ±è;

Effective Date &²Ô²ú²õ±è;

fb88Care Rate &²Ô²ú²õ±è;

91318 

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, 3 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation, for intramuscular use 

09/11/2023 

TBD 

Pfizer BioN-Tech COVID-19 Vaccine – 5 years through 11 years old &²Ô²ú²õ±è;

°ä´Ç»å±ð &²Ô²ú²õ±è;

¶Ù±ð²õ³¦°ù¾±±è³Ù¾±´Ç²Ô &²Ô²ú²õ±è;

Effective Date &²Ô²ú²õ±è;

fb88Care Rate &²Ô²ú²õ±è;

91319 

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, 10 mcg/0.2 mL dosage, tris-sucrose formulation, for intramuscular use 

09/11/2023 

TBD 

Pfizer BioN-Tech COVID-19 Vaccine – 12 years and older &²Ô²ú²õ±è;

°ä´Ç»å±ð &²Ô²ú²õ±è;

¶Ù±ð²õ³¦°ù¾±±è³Ù¾±´Ç²Ô &²Ô²ú²õ±è;

Effective Date &²Ô²ú²õ±è;

fb88Care Rate &²Ô²ú²õ±è;

91320 

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, 30 mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular use 

09/11/2023 

TBD 

 &²Ô²ú²õ±è;

Moderna COVID-19 Vaccine – 6 months through 11 years old &²Ô²ú²õ±è;

°ä´Ç»å±ð &²Ô²ú²õ±è;

¶Ù±ð²õ³¦°ù¾±±è³Ù¾±´Ç²Ô &²Ô²ú²õ±è;

Effective Date &²Ô²ú²õ±è;

fb88Care Rate &²Ô²ú²õ±è;

91321 

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, 25 mcg/0.25 mL dosage, for intramuscular use 

09/11/2023 

TBD 

Moderna COVID-19 Vaccine – 12 years and older 

°ä´Ç»å±ð &²Ô²ú²õ±è;

¶Ù±ð²õ³¦°ù¾±±è³Ù¾±´Ç²Ô &²Ô²ú²õ±è;

Effective Date &²Ô²ú²õ±è;

fb88Care Rate &²Ô²ú²õ±è;

91322 

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, 50 mcg/0.5 mL dosage, for intramuscular use 

09/11/2023 

TBD 

 

Novavax COVID-19 Vaccine – 12 years and older &²Ô²ú²õ±è;

°ä´Ç»å±ð &²Ô²ú²õ±è;

¶Ù±ð²õ³¦°ù¾±±è³Ù¾±´Ç²Ô &²Ô²ú²õ±è;

Effective Date &²Ô²ú²õ±è;

fb88Care Rate &²Ô²ú²õ±è;

91304 

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, 5 mcg/0.5 mL dosage, for intramuscular use 

08/14/2023 

TBD 

 

COVID-19 Vaccine Administration 

°ä´Ç»å±ð &²Ô²ú²õ±è;

¶Ù±ð²õ³¦°ù¾±±è³Ù¾±´Ç²Ô &²Ô²ú²õ±è;

Effective Date &²Ô²ú²õ±è;

fb88Care Rate &²Ô²ú²õ±è;

90480 

Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, single dose 

09/11/23 

$39.11 

Note: The COVID-19 vaccine administration code will be added for  &²Ô²ú²õ±è;

 

 

Discontinued COVID-19 Vaccine Codes 

Code 

Description 

Effective Date 

End Date 

0041A 

Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, preservative free, 5 mcg/0.5 mL dosage; first dose 

7/13/2022 

 09/12/2023&²Ô²ú²õ±è;

0042A 

Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, preservative free, 5 mcg/0.5 mL dosage; second dose 

7/13/2022 

 09/12/2023&²Ô²ú²õ±è;

0044A 

Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, recombinant spike protein nanoparticle, saponinbased adjuvant, preservative free, 5 mcg/0.5 mL dosage; booster dose 

10/19/2022 

 09/12/2023&²Ô²ú²õ±è;

91312 

Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine, mRNALNP, bivalent spike protein, preservative free, 30 mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular use  

8/31/2022 

 09/12/2023&²Ô²ú²õ±è;

0121A 

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; 1st Dose 

4/18/2023 

 09/12/2023&²Ô²ú²õ±è;

0124A 

Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine, mRNALNP, bivalent spike protein, preservative free, 30 mcg/0.3 mL dosage, tris-sucrose formulation, additional dose  

8/31/2022 

 09/12/2023&²Ô²ú²õ±è;

91313 

Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine, mRNALNP, spike protein, bivalent, preservative free, 50 mcg/0.5 mL dosage, for intramuscular use 

8/31/2022 

 09/12/2023&²Ô²ú²õ±è;

0134A 

Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine, mRNALNP, spike protein, bivalent, preservative free, 50 mcg/0.5 mL dosage, additional dose  

8/31/2022 

 09/12/2023&²Ô²ú²õ±è;

91314 

Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine, mRNALNP, spike protein, bivalent, preservative free, 25 mcg/0.25 mL dosage, for intramuscular use  

10/12/2022 

 09/12/2023&²Ô²ú²õ±è;

0141A 

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease COVID-19) vaccine, mRNA-LNP, spike protein,  bivalent, preservative free, 25 mcg/0.25 mL dosage, for intramuscular use; 1st dose 

4/18/2023 

 09/12/2023&²Ô²ú²õ±è;

0142A 

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease COVID-19) vaccine, mRNA-LNP, spike protein,  bivalent, preservative free, 25 mcg/0.25 mL dosage, for intramuscular use; 2nd dose 

4/18/2023 

 09/12/2023&²Ô²ú²õ±è;

0144A 

Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNLNP, spike protein, bivalent, preservative free, 25 mcg/0.25 mL dosage, additional dose 

10/12/2022 

 09/12/2023&²Ô²ú²õ±è;

91315 

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, bivalent spike protein, preservative free, 10 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation, for intramuscular use  

10/12/2022 

 09/12/2023&²Ô²ú²õ±è;

0151A 

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, bivalent spike protein, preservative free, 10 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation, for intramuscular use; 1st dose 

4/18/2023 

 09/12/2023&²Ô²ú²õ±è;

0154A 

Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine, mRNALNP, bivalent spike protein, preservative free, 10 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation, additional dose 

10/12/2022 

 09/12/2023&²Ô²ú²õ±è;

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 

12/8/2022 

 09/12/2023&²Ô²ú²õ±è;

0164A 

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, 10 mcg/0.2 mL dosage, booster dose 

12/8/2022 

 09/12/2023&²Ô²ú²õ±è;

91317 

Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine, mRNALNP, bivalent spike protein, preservative free, 3 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation, for intramuscular use 

12/8/2022 

 09/12/2023&²Ô²ú²õ±è;

0171A 

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; 1st dose 

4/18/2023 

 09/12/2023&²Ô²ú²õ±è;

0172A 

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; 2nd dose 

4/18/2023 

 09/12/2023&²Ô²ú²õ±è;

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  

12/8/2022 

 09/12/2023&²Ô²ú²õ±è;

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, additional dose  

3/14/2023 

 09/12/2023&²Ô²ú²õ±è;

 

Providers may visit the fb88 CDC Immunization Program Website for up-to-date information on administering and ordering COVID-19 vaccines and booster doses. â€¯â€¯&²Ô²ú²õ±è;

If you have questions about COVID-19 vaccines or their administration, please contact your Provider Relations Specialist.   &²Ô²ú²õ±è;