AMA – Update to COVID-19 Vaccine CPT Codes
The American Medical Association (AMA) announced on September 3, 2021 that the CPT code set has been updated by the CPT Editorial Panel to include vaccine and administration codes that are unique to a new formulation of the COVID-19 vaccine developed by Pfizer. The new formulation is based on a tris-sucrose buffer rather than the phosphate buffer present in the original formulation.
The provisional CPT codes will be effective for use on the condition that tris-sucrose formulation of Pfizer’s COVID-19 vaccine receives approval or emergency use authorization from the FDA.
For quick reference, the new vaccine and administration codes assigned to the tris-sucrose formulation of Pfizer’s COVID-19 vaccine are:
Pfizer vaccine code (tris-sucrose formulation)
91305 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular use
Pfizer administration codes (tris-sucrose formulation)
0051A 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/0.3 mL dosage, tris-sucrose formulation; first dose
0052A 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/0.3 mL dosage, tris-sucrose formulation; second dose
0053A 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/0.3 mL dosage, tris-sucrose formulation; third dose
In addition to the new vaccine-specific product CPT codes, the CPT Editorial Panel has approved provisional CPT codes for booster doses of COVID-19 vaccines created by Moderna and Pfizer. While the Pfizer booster is likely to remain the same dose as the existing formulation, the Moderna booster is likely to be delivered at a different dose from the existing formulation. For this reason, a new vaccine code was created for the Moderna booster vaccine. These provisional CPT codes will be effective for use on the condition that booster doses of the COVID-19 vaccines created by Moderna and Pfizer receive approval or authorization from the FDA.
For quick reference, the new vaccine and administration codes assigned to the tris-sucrose formulation of Pfizer’s COVID-19 vaccine are:
Moderna booster code
91306 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 50 mcg/0.25 mL dosage, for intramuscular use
Moderna booster administration code
0064A 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, 50 mcg/0.25 mL dosage, booster dose
Pfizer booster administration codes (original formulation and tris-sucrose)
0004A 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/0.3 mL dosage, diluent reconstituted; booster dose
0054A 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/0.3 mL dosage, tris-sucrose formulation; booster dose
Short, medium and long descriptors for all the new vaccine-specific CPT codes can be accessed on the AMA website, along with other recent modifications to the CPT code set that have helped streamline the public health response to the SARS-CoV-2 virus and the COVID-19 disease.
To read the full AMA press release, click here. AMA also offers a vaccine code finder resource to help identify the appropriate CPT code combination for the type and dose of COVID-19 vaccine provided to each patient.