COVID-19 Pfizer Vaccine Administration Procedure Codes 0001A and 0002A Rate Change Effective 4/1/2021.

On December 18, 2020, in accordance with the FDA’s issuance of Emergency Use Authorization for the Pfizer COVID-19 Vaccine, vaccine administration procedure codes 0001A and 0002A are benefits for Texas Medicaid for individuals 18 years of age and older. Vaccine procedure code 91300 is informational only while the vaccine is distributed to providers free of charge.

Providers should reference the table below when submitting claims for vaccine administration:

Procedure codes 0001A and 0002A are benefits for the following providers and places of service:

Places of Service Provider Types
Office Physician Assistant, Nurse Practitioner, Clinical Nurse Specialist, Physician, Physician Groups, Certified Nurse Midwife, Pharmacist, CCP Provider, Nephrology (Hemodialysis, Renal Dialysis), Pharmacy, Clinic/Group Practice, Licensed Midwife, Registered Nurse, County Indigent Health Care Program
Outpatient Hospital Nephrology (Hemodialysis, Renal Dialysis), Hospital Providers, Renal Dialysis Facility
Home Physician Assistant, Nurse Practitioner, Clinical Nurse Specialist, Physician, Physician Groups, CCP Provider, Clinic/Group Practice
Other Locations Physician Assistant, Nurse Practitioner, Clinical Nurse Specialist, Physician, Physician Groups, CCP Provider, Clinic/Group Practice, County Indigent Health Care Program

Providers should reference the table below when submitting claims for the COVID-19 vaccine and vaccine administration:

Providers should bill CPT 91300 with a charge of $0.01 as this code is informational.  The Vaccines will Pay as follows beginning 4/1/2021:

**Rate subject to change based on TMHP notice**

CPT Code CPT Short Descriptor Labeler Name Vaccine Procedure Name Payment Allowance as of 4/1/2021
91300 SARSCOV2 VAC 30MCG/0.3ML IM Pfizer Pfizer-Biontech Covid-19 Vaccine $0.01
0001A ADM SARSCOV2 30MCG/0.3ML 1ST Pfizer Pfizer-Biontech Covid-19 Vaccine Administration – First Dose $40.00
0002A ADM SARSCOV2 30MCG/0.3ML 2ND Pfizer Pfizer-Biontech Covid-19 Vaccine Administration – Second Dose $40.00