Apple Health (Medicaid) Provider Alert
What changed?
New procedure code
Retroactive for claims with dates of service on and after May 17, 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® Short Labeler Vaccine/Procedure
Code Description Name Name
0074A ADM SARSCV2 Pfizer Pfizer BioNTech
10MCG Covid-19 Ped
TRS-SUCR B Vaccine Admin Booster
New diagnosis code for administration of COVID-19 vaccines
Effective for claims with dates of service on and after June 1, 2022, when billing for the administration of COVID-19 vaccines, providers may use ICD diagnosis code Z71.85 and the CR modifier in the primary position on claims.
HCA revised the Apple Health (Medicaid) COVID-19 vaccine clinical policy. See HCA’s Provider billing guides and fee schedules, under COVID-19.
COVID-19 Fee Schedule
HCA revised the Emergency COVID-19 Fee Schedule. See HCA’s Provider billing guides and fee schedules, under COVID-19.
CPT® codes and descriptions only are copyright 2021 American Medical Association.
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