The U.S. Food and Drug Administration (FDA) amended the emergency use authorization for the Pfizer-BioNTech COVID-19 Vaccine to expand the use of a single booster dose to include use in individuals age 12 through 15 (previously approved for ages 16 and older).
The FDA also shortened the time between the second Pfizer dose and the booster shot to five months (previously recommendation was at six months after primary series) for all ages.
Beginning Jan. 3, 2022, Medicaid and NC Health Choice will cover the Pfizer-BioNTech Covid-19 vaccine booster dose for administration to individuals age 12 and older and five months after the administration of the second dose (for all ages). Payment amount for administration code 0004A will be equivalent as for the administration of other doses of the COVID-19 vaccine.
Please follow all other conditions of claims billing as mentioned in Bulletin #186 to process claims appropriately.
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