COVID-19 Updates

On Monday, September 12, 2022, in CMS's mlnconnects newsletter the Department of Health & Human Services (HHS), through CMS announced: that people with Medicare, Medicaid, Children’s Health Insurance Program coverage, private insurance coverage, or no health coverage can get COVID-19 vaccines, including the updated Moderna and Pfizer-BioNTech COVID-19 vaccines, at no cost, for as long as the…Read More

On August 18, 2022, CMS published a special edition of their newsletter that announced that "Secretary of Health and Human Services (HHS) Xavier Becerra extended the existing COVID-19 public health emergency (PHE) through October 15, 2022 – and has committed to providing states, health care providers, and other stakeholders a 60-day notice before ending the…Read More

From CMS: The FDA amended the Moderna COVID-19 vaccine emergency use authorization (PDF) to authorize use for all patients 6 months – 17 years old. CMS issued 7 new CPT codes effective June 17, 2022: Code 91311 for vaccine product: Long descriptor: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative…Read More

From CMS: On June 17, 2022, the FDA amended the Pfizer-BioNTech COVID-19 vaccine emergency use authorization (PDF) to authorize use for all patients 6 months – 4 years old. Get important vial and dosing information. CMS issued new CPT codes effective June 17, 2022: Code 91308 for vaccine product: Long descriptor: Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2)…Read More

On March 29, 2022, the FDA amended the Moderna COVID-19 vaccine emergency use authorization (PDF), including new packaging for vaccine boosters (blue cap). CMS issued new codes, effective March 29, 2022, for the vaccine booster and administration: Code: 91309 Long descriptor: Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free,…Read More

On December 16, 2021, CMS announced the Protecting Medicare and American Farmers from Sequester Cuts Act impacts payments for all Medicare Fee-for-Service (FFS) claims: No payment adjustment through March 31, 2022 1% payment adjustment April 1 – June 30, 2022 2% payment adjustment beginning July 1, 2022Read More

Effective October 20, 2021, FDA amended the emergency use authorizations for the Moderna (PDF) and Jansen (Johnson & Johnson) COVID-19 vaccines to allow for use of a single booster dose for certain populations. More CMS Resources: COVID-19 Vaccines and Monoclonal Antibodies Payment Allowances & Effective Dates CMS News Alert Regarding COVID-19 Booster Coverage COVID-19 provider toolkit including: Payment rates for administering…Read More

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…Read More

The American Medical Association (AMA) announced on August 16, 2021, that the Current Procedural Terminology (CPT®) code set is ready for the rollout of third doses of the Pfizer and Moderna COVID-19 vaccines. The CPT Editorial Panel has expedited approval of a new administration code that is unique to a third dose of the current…Read More

If you received an accelerated or advance payment, the Centers for Medicare & Medicaid Services (CMS) will begin to recoup any outstanding balance from any payments due to you from your Medicare claims. This process began as soon as 3/30/2021, depending upon the one-year anniversary of when you received your first advance payment. CMS will…Read More