COVID-19 Vaccine clinical policy update

Washington State Health Care Authority sent this bulletin at 08/01/2022 09:05 AM PDT

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Apple Health (Medicaid) Provider Alert

What changed?

The Health Care Authority (HCA) added the following procedure codes to the Apple Health (Medicaid) COVID-19 vaccine clinical policy and fee schedule:

CPT® or HCPCS code	Short description	Effective Date
0091A	ADM SARSCOV2 50 MCG/.5 ML1ST	06/17/2022
0092A	ADM SARSCOV2 50 MCG/.5 ML2ND	06/17/2022
0093A	ADM SARSCOV2 50 MCG/.5 ML3RD	06/17/2022
91311	SARSCOV2 VAC 25MCG/0.25 ML IM	06/17/2022
0111A	ADM SARSCOV2 25 MCG/0.25 ML1ST	06/17/2022
0112A	ADM SARSCOV2 25 MCG/0.25 ML2ND	06/17/2022
0113A	ADM SARSCOV2 25 MCG/0.25 ML3RD	06/17/2022
91304	SARSCOV2 VAC 5MCG/0.5ML IM	07/13/2022
0041A	ADM SARSCOV2 5 MCG/0.5 ML1ST	07/13/2022
0042A	ADM SARSCOV2 5 MCG/0.5 ML2ND	07/13/2022

HCA revised the Apple Health (Medicaid) COVID-19 vaccine clinical policy. See HCA’s Provider billing guides and fee schedules, under COVID-19, Policies and billing guidance.

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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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.