AdministrativeCommercialJune 14, 2023

Update for Covid-19 vaccine admin codes

Beginning January 1, 2024, Empire became Anthem. This article, published under the former brand, now applies to Anthem.

In the April 2023 edition of Provider News, we announced that beginning with dates of service on or after July 1, 2023, reimbursement for COVID-19 vaccine administration codes will be reduced. Following our announcement, the American Medical Association (AMA) released new COVID-19 vaccine administration codes (see Table 1 below) with an effective date of April 18, 2023.  

For dates of service on April 18, 2023, through June 30, 2023, Empire BlueCross BlueShield (Empire) will reimburse the COVID-19 vaccine administration codes listed in Table 1 at the current rates established for other COVID-19 vaccine administration codes (see April 2023 edition of Provider News for the list of other COVID-19 vaccine administration codes).

Beginning with dates of service on or after July 1, 2023, the codes listed in Table 1 below will be adjusted to align with the new COVID-19 vaccine administration code pricing, as previously communicated in the April 2023 edition of Provider News, at rates equal to the rates established by Empire for non-COVID-19 vaccine administration (for example, flu). In the event new COVID-19 vaccine administration codes are released, these codes will be reimbursed at the established Empire rates equal to the non-COVID-19 vaccine administration rates.

Table 1:

CPT® / HCPCS code  

Description/nomenclature 

0121A

Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease COVID-19) vaccine, mRNA-LNP, bivalent spike protein, preservative free, 30 mcg/0.3 mL dosage, tris-sucrose formulation; single dose

0141A

Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease COVID-19) vaccine, mRNA-LNP, spike protein, bivalent, preservative free, 25 mcg/0.25 mL dosage; first dose

0142A

Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease COVID-19) vaccine, mRNA-LNP, spike protein, bivalent, preservative free, 25 mcg/0.25 mL dosage; second dose

0151A

Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease COVID-19) vaccine, mRNA-LNP, bivalent spike protein, preservative free, 10 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation; single dose

0171A

Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease COVID-19) vaccine, mRNA-LNP, bivalent spike protein, preservative free, 3 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation; first dose

0172A

Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease COVID-19) vaccine, mRNA-LNP, bivalent spike protein, preservative free, 3 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation; second dose

NYBCBS-CM-027159-23-SRS27033