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COVID-19 Vaccine Administration Codes Are Now Benefits for Medicaid and CHIP

Date: 08/23/22

Effective for dates of service on or after June 17, 2022, COVID-19 vaccine administration codes 0091A, 0092A, and 0093A are benefits for Superior HealthPlan Medicaid (STAR, STAR Health, STAR Kids, and STAR+PLUS) and CHIP members for the administration of the Moderna COVID-19 vaccine to individuals 6 through 11 years of age.

Vaccine procedure code 91309 continues to be informational only while the vaccine is distributed to providers free of charge.

Procedure codes 0091A, 0092A, and 0093A are benefits for the following provider specialties when administered in the places of service listed below:

Place of Service

Provider Type

Office

Physician Assistant (PA), Nurse Practitioner (NP), Clinical Nurse Specialist (CNS), Physician, Pharmacist, Certified Nurse Midwife (CNM), Federally Qualified Healthcare Centers (FQHCs), Nephrology (Hemodialysis, Renal Dialysis), Rural Health Clinics (RHCs), Pharmacy

Home

PA, NP, CNS, Physician, Home Health Agency, Comprehensive Care Program (CCP) Provider

Outpatient Hospitals

FQHCs, Hospitals, Nephrology (Hemodialysis, Renal Dialysis), Renal Dialysis Facility, RHCs

Other Locations

PA, NP, CNS, Physician, FQHCs, CCP Provider, RHCs

As of June 17, 2022, procedure code M0201 (COVID-19 vaccine administration inside a patient’s home) can be billed in the home setting with procedure code 0091A, 0092A, or 0093A for individuals 6 through 11 years of age.

Superior will reprocess affected claims submitted with these procedure codes and dates of service on or after June 17, 2022. Providers are not required to appeal the claims unless claims are denied for additional reasons. Providers may bill Superior retroactively for COVID-19 vaccine administration codes 0091A, 0092A, and 0093A for individuals 6 through 11 years of age, however, the 95-Day timely filing deadline is still applicable.

For more information about enrolling to administer COVID-19 vaccines, providers are encouraged to visit HHS’s Vaccination Provider Enrollment webpage.