Coding for COVID-19 Vaccine Administration
The American Medical Association (AMA) has published an update to the Current Procedural Terminology (CPT®) code set that includes new vaccine-specific codes to report immunizations for the new coronavirus, SARS-CoV-2.Working closely with the Centers for Disease Control and Prevention, the CPT Editorial Panel has approved a unique CPT code for each of three coronavirus vaccines (Pfizer-BioNTech, Moderna, and AstraZeneca/University of Oxford, as well as administration codes unique to each vaccine.
The new CPT codes clinically distinguish each coronavirus vaccine for better tracking, reporting and analysis that supports data-driven planning and allocation. These CPT codes report the actual work of administering the vaccine, in addition to all necessary counseling provided to patients or caregivers and updating the electronic record. The AMA/Specialty Society RVS Update Committee (RUC) submitted recommendations for work relative values and direct practice expense inputs to the Centers for Medicare & Medicaid Services (CMS). In the case of the COVID-19 vaccine requiring two doses, the total physician work resources required for the first dose will be equivalent to those required for the second dose to account for the possibility that a patient may not return to the same physician or even the same physician group for the second dose administration. The RUC recommends a work RVU of 0.20 and intra-service time of 7 minutes for CPT codes 0001A, 0002A, 0011A and 0012A.
The CPT codes are available prior to the public availability of the vaccines to facilitate the updating of health care electronic systems across the U.S.
The Category I CPT codes and long descriptors for the vaccine products are:
- 91300: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3mL dosage, diluent reconstituted, for intramuscular use.
- 91301: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 100 mcg/0.5mL dosage, for intramuscular use.
- 91302: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, DNA, spike protein, chimpanzee adenovirus Oxford 1 (ChAdOx1) vector, preservative free, 5x1010 viral particles/0.5mL dosage, for intramuscular use.
The coronavirus vaccine administration codes are specific to the coronavirus vaccine and the dosage. Vaccine administration codes report the work of administering the vaccine, counseling the patient or caregiver, and documenting the medical record.
0001A
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3mL dosage, diluent reconstituted; first dose. (The 0001A COVID-19 vaccine administration CPT code is for the first dose of the Pfizer vaccine only.)0002A
Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3mL dosage, diluent reconstituted; second dose. (The 0002A COVID-19 vaccine administration CPT code is for the second dose of the Pfizer vaccine only.)011A
Immunization administration by intramuscular injection of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 100 mcg/0.5mL dosage; first dose. (The 0011A COVID-19 vaccine administration CPT code is for the first dose of the Moderna vaccine only.)0012A
Immunization administration by intramuscular injection of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 100 mcg/0.5mL dosage; second dose. (The 0012A COVID-19 vaccine administration CPT code is for the second dose of the Moderna vaccine only.)Example of how to bill for the Pfizer COVID-19 vaccine:
Pfizer COVID-19 Vaccine First Dose:- Vaccine CPT: 91300
- Administration: 0001A
- ICD-10: Z23
- NDC: 59267-1000-01
- Vaccine CPT: 91300
- Administration: 0002A
- ICD-10: Z23
- NDC: 59267-1000-01
Example of how to bill for the Moderna COVID-19 vaccine:
Moderna COVID-19 Vaccine First Dose:- Vaccine CPT: 91301
- Administration: 0011A
- ICD-10: Z23
- NDC: 80777-0273-10
- Vaccine CPT: 91301
- Administration: 0012A
- ICD-10: Z23
- NDC: 80777-0273-10