On 04/23/2021, the FDA and CDC recommended the lift of the pause on Johnson and Johnson (Janssen) Covid-19 Vaccine use following a through safety review.
- Use of the Janssen COVID-19 Vaccine should be resumed in the United States.
- The FDA and CDC have confidence that this vaccine is safe and effective in preventing COVID-19.
- The FDA has determined that the available data show that the vaccine’s known and potential benefits outweigh its known and potential risks in individuals 18 years of age and older.
- At this time, the available data suggest that the chance of TTS occurring is very low, but the FDA and CDC will remain vigilant in continuing to investigate this risk.
- Health care providers administering the vaccine and vaccine recipients or caregivers should review the Janssen COVID-19 Vaccine Fact Sheet for Healthcare Providers Administering Vaccine (Vaccination Providers)external icon and Fact Sheet for Recipients and Caregiversexternal icon, which have been revised to include information about the risk of this syndrome, which has occurred in a very small number of people who have received the Janssen COVID-19 Vaccine.
On February 27, 2021, in accordance with the FDA’s issuance of Emergency Use Authorization for the Janssen (Johnson & Johnson) COVID-19 Vaccine, vaccine administration procedure codes 0031A is a benefit for Texas Medicaid for individuals 18 years of age and older. Vaccine procedure code 91303 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 0031A is a benefit 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 bill CPT 91303 with a charge of $0.01 as this code is informational. Beginning with Dates of Service 4/1/2021 and after the Vaccines will Pay as follows:
**Rate subject to change based on TMHP notice**
|CPT Code||CPT Short Descriptor||Labeler Name||Labeler Name||Payment Allowance|
|91303||SARSCOV2 VAC AD26 .5ML IM||Janssen||Janssen (Johnson & Johnson) Covid-19 Vaccine||$0.01|
|0031A||ADM SARSCOV2 VAC AD26 .5ML||Janssen||Janssen (Johnson & Johnson) Covid-19 Vaccine||$40.00|