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COVID-19 Vaccine Administration Information

Please see the table below for the appropriate procedure codes to be used when billing Health Partners Plans (HPP) for the administration of COVID-19 vaccines administered to HPP members and the reimbursements applicable to those codes. HPP will follow both the Centers for Medicaid & Medicare Services (CMS) and the Pennsylvania Department of Human Services (DHS) policies related to coding and reimbursement.

It is important to note that the coding and reimbursement detailed in this communication is applicable to all provider types and places of service.

Note for Urgent Care Centers: Vaccine administration should not be billed as an urgent care visit. Urgent Care Centers will require a contract amendment for the vaccine administration codes and will receive additional communication.

Vaccine Administration Code(s) Medicaid Medicare CHIP Non-Par Providers Medicaid & CHIP
0001A (1st dose)

0002A (2nd dose)

$10.00 (DHS Fee Schedule)* $0

Provider is required to bill CMS

$10.00 (DHS Fee Schedule)* $10.00 (DHS Fee Schedule)*
0011A (1st dose)

0012A (2nd dose)

$10.00 (DHS Fee Schedule)*

$0
Provider is required to bill CMS

$10.00 (DHS Fee Schedule)* $10.00 (DHS Fee Schedule)*

*As may be updated by DHS

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