COVID-19 vaccine clinical policy updates

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Apple Health (Medicaid) Provider Alert

Attention providers

What changed?

Retroactive to claims with dates of service on and after October 20, 2021, the Health Care Authority updated the Apple Health (Medicaid) COVID-19 vaccine clinical policy.

Specifically, HCA added the following procedure codes to the COVID Vaccine and Vaccine Administration table:

CPT® Code

 Short Description

 Comments

91306

SARSCOV2 VAC 50 MCG/0.25 ML IM

Moderna booster

0064A

ADM SARSCOV 2 50 MCG/0.25 MLBST

Moderna booster

0034A

ADM SARSCOV2 VAC AD26 .5ML B

Janssen booster Use with CPT® code 91303 SARSCOV2 VAC AD26 .5ML IM

COVID-19 Fee Schedule

HCA revised the Emergency COVID-19 Fee Schedule, updated October 28, 2021. See HCA’s Provider billing guides and fee schedules, under COVID-19.

CPT® codes and descriptions only are copyright 2020 American Medical Association