Is there now an effective date available for the pediatric bivalent Moderna and Pfizer COVID-19 vaccine booster doses?
Yes. CMS announced that CPT codes for the Moderna bivalent booster vaccine for children, ages 6 through 11 years of age, (91314, 0144A) and the Pfizer-BioN Tech bivalent booster vaccine for individuals aged 5 through 11 years (91315, 0154A) will be effective October 12, 2022. For your convenience, we have provided the long descriptions for each new booster-specific code below.
Moderna COVID-19 Vaccine, Bivalent Product and Administration – Booster Dose
- 91314: 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
0144A: 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, 25 mcg/0.25 mL dosage, booster dose
Pfizer-BioNTech COVID-19 Vaccine, Bivalent Product and Administration – Booster Dose
The Novavax vaccine product code (CPT 91304) remains unchanged, and the long descriptor is provided below for your convenience:
- 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
0154A: 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, 10 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation, booster dose
We remind providers that per CMS directive, if you receive a COVID-19 vaccine product free of charge, you should only bill for the administration services and not the drug products themselves. For providers whose systems require a product code to bill for the administration, a token charge of $0.01 may be reported for the drug product.
For additional information, see:
FDA News Release, “Coronavirus (COVID-19) Update: FDA Authorizes Moderna and Pfizer-BioNTech Bivalent COVID-19 Vaccines for Use as a Booster Dose in Younger Age Groups”
https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-moderna-and-pfizer-biontech-bivalent-covid-19-vaccines
CMS COVID-19 Vaccines website
https://www.cms.gov/medicare/medicare-part-b-drug-average-sales-price/covid-19-vaccines-and-monoclonal-antibodies