On Dec. 9, 2021, the U.S. Food and Drug Administration amended the emergency use authorization (EUA) for the Pfizer-BioNTech COVID-19 vaccine, authorizing the use of a single booster dose for administration to individuals ages 16 and 17 at least six months after completion of primary vaccination with the Pfizer-BioNTech COVID-19 Vaccine.
Soon after, the CDC expanded the recommendation for boosters to include those ages 16 and 17.
Beginning Dec. 9, 2021, Medicaid and NC Health Choice will cover the Pfizer-BioNTech COVID-19 vaccine booster dose for administration to individuals age 16 and older (until more information is available for the use of Moderna and Janssen vaccines for this age group). Payment amount for administration code 0004A will be equivalent as for the administration of other doses of the COVID-19 vaccine at $40 each.
Please follow all other conditions of claims billing as mentioned in Special Bulletin COVID-19 #186 to process claims appropriately.
Contact
NCTracks Contact Center: 800-688-6696