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 COVID-19 vaccine from Moderna. A new administration code for a third dose of the current COVID-19 vaccine from Pfizer was announced by the AMA on July 30.
The two vaccine administration codes are effective for immediate use as the U.S. Food and Drug Administration (FDA) has authorized third doses of COVID-19 vaccines from Pfizer and Moderna for certain people with weakened immune systems.
For quick reference, the CPT codes and long descriptors assigned to third dose administration of the current Pfizer and Moderna COVID-19 vaccines are:
0003A – 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; third dose
0013A – 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/0.5 mL dosage; third dose
These CPT codes and descriptors are used to report the actual work of administering the vaccine, in addition to all necessary counseling provided to patients or caregivers and updating the electronic record.
Short, medium and long descriptors for all the new vaccine-specific CPT codes can be accessed on the AMA website, along with several 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.
Additionally, on August 16, 2021, the Centers for Medicare and Medicaid Services (CMS) also announced coding and payment updates for additional doses of the Pfizer and Moderna vaccines per FDA guidelines.
Effective August 12, 2021, CMS will pay to administer additional doses of COVID-19 vaccines consistent with the FDA emergency use authorizations (EUAs), using CPT code 0003A for the Pfizer vaccine and CPT code 0013A for the Moderna vaccine. They will pay the same amount to administer this additional dose as they did for other doses of the COVID-19 vaccine (approximately $40 each).