COVID-19 Vaccine clinical policy update

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Apple Health (Medicaid) Provider Alert

What changed? 

Retroactive to dates of service on and after August 31, 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® or  
HCPCS code            Short description                               Labeler

91312               SARSCOV2 VAC BVL 30MCG/0.3M            Pfizer

0124A               ADM SARSCV2 BVL 30MCG/.3ML B           Pfizer

91313               SARSCOV2 VAC BVL 50MCG/0.5ML           Moderna         

0134A               ADM SARSCV2 BVL 50MCG/.5ML B           Moderna           

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.

CPT® codes and descriptions only are copyright 2021 American Medical Association