Which CPT codes should I use to report the newly authorized Moderna COVID-19 vaccine booster doses?

On October 20, 2021, the FDA amended the Emergency Use Authorizations for both the Janssen (J&J) and Moderna COVID-19 vaccines to allow for booster doses for certain patient populations. Additional clinical information regarding the timing of the booster doses and the populations for which they have been approved can be found in the FDA news release linked below.

In a subsequent MLN Connects Special Edition, published on October 22, 2021, CMS confirmed that it will cover the Janssen and Moderna booster doses retroactively back to October 20, 2021 – the date the FDA amended the Emergency Use Authorizations for both vaccines.

The CMS COVID-19 Vaccines and Monoclonal Antibodies homepage has been updated to show that Moderna booster CPTs 91306 and 0064A are retroactively effective beginning 10/20/21. We have provided the long descriptions for both codes below for your convenience. CPT 91306 represents the Moderna booster vaccine product (which is half the dose of the primary series), while 0064A reflects the administration service

  • 91306: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 50 mcg/0.25 mL dosage, for intramuscular use
  • 0064A: Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine, mRNALNP, spike protein, preservative free, 50 mcg/0.25 mL dosage, booster dose

Note, the AMA has not yet created CPT codes specific to booster doses of the Janssen vaccine. We would advise checking with your payers if primary dose Janssen CPT codes (91303/0031A) should be utilized, or if claims for Janssen booster doses should be held until booster specific CPTs are established. We will be monitoring the AMA website closely and will provide additional updates as needed.

Resources:

FDA news release, “Coronavirus (COVID-19) Update: FDA Takes Additional Actions on the Use of a Booster Dose for COVID-19 Vaccines”
https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-takes-additional-actions-use-booster-dose-covid-19-vaccines

CMS MLN Connects Special Edition, COVID-19: Moderna & Jansen (J&J) Booster Shots
https://www.cms.gov/outreach-and-educationoutreachffsprovpartprogprovider-partnership-email-archive/2021-10-22-mlnc-se