COVID-19 Vaccine clinical policy update

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Apple Health (Medicaid) Provider Alert

Attention providers

What changed? 

Retroactive to dates of service on and after October 12, 2022, the Health Care Authority (HCA) added the following COVID vaccine booster procedure codes to the Apple Health (Medicaid) COVID-19 vaccine clinical policy and fee schedule:

CPT® or
HCPCS code            Short description                               Labeler

91314                      SARSCOV2 VAC BVL 25MCG/0.25ML      Moderna   

0144A                      ADM SARSCV2 BVL 25MCG/.25ML B      Moderna              

91315                      SARSCOV2 VAC BVL 10MCG/0.2ML        Pfizer

0154A                      ADM SARSCV2 BVL 10MCG/.2ML B        Pfizer

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.