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 fb88Care Services (OMS) sent an announcement that we will cover the and 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 

fb88Care 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 

fb88Care 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  

 

Providers may visit the fb88 CDC Immunization Program Website for up-to-date information on administering and ordering COVID-19 vaccine and booster doses. The fb88 CDC Immunization Program also released this 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. &²Ô²ú²õ±è;