COVID-19 Vaccine, Monoclonal Antibodies and Administration - JF Part A
COVID-19 Vaccine, Monoclonal Antibodies and Administration
HCPCS/CPT Codes
CMS has started the process of closing out the effective dates for certain COVID vaccines and monoclonal antibodies. Please see CMS COVID-19 Vaccines and Monoclonal Antibodies page for the most up-to-date list of these codes, including their effective date periods.
New CPT effective October 3, 2023:
- 91304 - COVID-19 Vaccine, 5 mcg/0.5 mL
- With CPT 90480 COVID-19 Vaccine Administration below
- Beneficiary cost-sharing waived
New CPTs effective September 11, 2023:
- 90480 - COVID-19 Vaccine Administration
- 91318 - COVID-19 Vaccine, 3 mcg/0.2 mL
- 91319 - COVID-19 Vaccine, 10 mcg
- 91320 - COVID-19 Vaccine, 30 mcg
- 91321 - COVID-19 Vaccine, 25 mcg
- 91322 - COVID-19 Vaccine, 50 mcg
Coverage
- All Medicare beneficiaries
- Original Medicare no longer pays COVID-19 vaccine or monoclonal antibody product administration claims for Medicare Advantage beneficiaries on or after January 1, 2022, unless the beneficiary in a Medicare Advantage plan has chosen to enroll in hospice.
Payment
Copayment/coinsurance waived; Deductible waived
Pricing
For payment rates for COVID-19 vaccine administration, visit the COVID-19 Vaccine and Monoclonal Antibodies Pricing webpage on CMS.
Resources
- CDC COVID-19 Vaccination Communication Toolkit for medical centers, clinics, and clinicians
- CMS COVID-19 End of Public Health Emergency FAQs
- CMS COVID-19 FAQs (PDF):
- CMS COVID-19 Provider Toolkit
- CMS Monoclonal Antibody COVID-19 Infusion
- CMS Office of Minority Health COVID-19 Resources on Vulnerable Populations
- CMS Vaccine Pricing
- Healthcare System Cybersecurity: Readiness & Response Considerations
- FDA COVID-19 Vaccines
- PC-ACE Software
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