What are the CPT codes for the recently authorized COVID-19 vaccine manufactured by Novavax?
On July 13, 2022, the FDA approved an emergency use authorization (EUA) for the Novavax COVID-19 vaccine (CPT 91304), along with its associated administration codes for the first dose (CPT 0041A), and administration for the second dose (CPT 0042A). The CPT codes are effective July 13, 2022 which coincides with the FDA approval date. For your convenience, the long descriptors of the CPT codes are provided below:
91304 - Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, preservative free, 5 mcg/0.5mL dosage, for intramuscular use
0041A - Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) (coronavirus disease [COVID-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, preservative free, 5 mcg/0.5mL dosage; first dose
0042A - second dose
Craneware reminds providers that CMS expects you not to charge for a COVID-19 vaccine product that you received free of charge. When the vaccine is free, you should only bill for the administration services and not the drug product. If your system requires a product code to bill for the administration, a token charge of $0.01 may be reported for the drug product.
Also remember, there may be a delay in other payers incorporating these new codes into their claims processing systems. Craneware advises confirming code availability with your respective payers prior to claim submission.
Resources:
FDA Press Release
https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-emergency-use-novavax-covid-19-vaccine-adjuvanted