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Effective for dates of service on or after August 31, 2022, in accordance with the U.S. Food and Drug Administration’s Emergency Use Authorization, COVID-19 vaccine administration codes 0124A and 0134A are benefits of Medicaid and CHIP for the administration of the following:

  • Pfizer COVID-19 Omicron-specific booster vaccine to individuals 12 years of age and older.
  • Moderna COVID-19 Omicron-specific booster vaccine to individuals 18 years of age and older.

The Health and Human Services Commission will cover procedure codes 0124A and 0134A as non-risk payments. Vaccine procedure codes 91312 and 91313 are informational only while the vaccines are distributed to providers free of charge.

Procedure codes 0124A and 0134A are benefits of Medicaid and CHIP for the following providers and places of service:

As of August 31, 2022, procedure code M0201 (COVID-19 vaccine administration inside a patient’s home) can be billed in the home setting with procedure code 0124A or 0134A.

Resources:

Coronavirus (COVID-19) Update: FDA Authorizes Moderna, Pfizer-BioNTech Bivalent COVID-19 Vaccines for Use as a Booster Dose | FDA

Contact:

Email ProviderRelations@cfhp.com or call 210-358-6294

Beginning September 1, 2024 Community First Health Plans, Inc. will be adding STAR+PLUS to its line of health care products.

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