MedicaidBilling CodesMedium impact
COVID-19 vaccine clinical policy updates
Washington Apple Health·WA · Family Medicine, Internal Medicine, Pediatrics +1 more·Medical Policy
Effective date
May 17, 2022
We identified it
Jun 20, 2026
Summary
Washington State Apple Health (Medicaid) added new COVID-19 vaccine procedure code 0074A (Pfizer pediatric booster) retroactive to May 17, 2022, and authorized use of diagnosis code Z71.85 with CR modifier for vaccine administration starting June 1, 2022.
Action Required
Immediately: Billing team must update system to include CPT code 0074A for Pfizer pediatric COVID-19 booster administration (retroactive to May 17, 2022). Add ICD-10 code Z71.85 with CR modifier as allowable primary diagnosis for COVID-19 vaccine administration claims dated June 1, 2022 and after. Update encounter forms and billing software rules for Washington State Medicaid patients.