COVID-19 Vaccine clinical policy update, retroactive to 3/29/2022

Washington State Health Care Authority sent this bulletin at 04/19/2022 09:29 AM PDT

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Apple Health (Medicaid) Provider Alert

Attention providers

What changed?

Retroactive for claims with dates of service on and after March 29, 2022, the Health Care Authority (HCA) added the following procedure codes to the Apple Health (Medicaid) COVID-19 vaccine clinical policy and fee schedule:

CPT® Code	Short Description	Labeler Name	Vaccine/Procedure Name
91309	SARSCOV2 VAC 50MCG/0.5ML IM	Moderna	Moderna COVID-19 Vaccine Adult Booster 0.5 ML IM
0094A	ADM SARSCOV2 50MCG/0.5 MLBST	Moderna	Moderna COVID-19 Administration Adult Booster 0.5 ML IM

HCA revised the Apple Health (Medicaid) COVID-19 vaccine clinical policy. See HCA’s Information about novel coronavirus (COVID-19), under COVID-19 resources, Vaccine information.

COVID-19 Fee Schedule

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

About the Health Care Authority (HCA)

The Washington State Health Care Authority (HCA) is committed to whole-person care, integrating physical health and behavioral health services for better results and healthier residents.

HCA purchases health care for more than 2.5 million Washington residents through Apple Health (Medicaid), the Public Employees Benefits Board (PEBB) Program, the School Employees Benefits Board (SEBB) Program, and the COFA Islander Health Care Program. As the largest health care purchaser in the state, we lead the effort to transform health care, helping ensure Washington residents have access to better health and better care at a lower cost.

Please do not reply directly to this message. For more information, visit the HCA website, where you'll also find contact information.

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Nondiscrimination

The Washington State Health Care Authority (HCA) complies with all applicable federal and Washington state civil rights laws and is committed to providing equal access to our services. Visit HCA’s website to view complete nondiscrimination statements.