MedicaidBilling CodesMedium impact
COVID-19 vaccine clinical policy update, retroactive to 10/29/2021
Washington Apple Health·WA · Family Medicine, Internal Medicine, Pediatrics +1 more·Medical Policy
Effective date
Oct 29, 2021
We identified it
Jun 20, 2026
Summary
Washington State HCA added new COVID-19 pediatric vaccine billing codes (91305, 0051A-0054A) for Pfizer vaccines for patients 12+ years, retroactive to October 29, 2021. The updated COVID-19 vaccine policy and fee schedule are now available on HCA's website.
Action Required
Immediately: Billing team must update system to include new COVID-19 pediatric vaccine codes (91305, 0051A, 0052A, 0053A, 0054A) for Washington State Medicaid patients. Review and resubmit any denied claims for Pfizer pediatric COVID-19 vaccines with dates of service from October 29, 2021 forward. Download updated fee schedule from HCA website.