All PlansBilling CodesMedium impact
21-104 COVID-19 Vaccines: What You Need to Know
Health Net·CA·Prior Authorization
We identified it
Jun 20, 2026
Summary
This policy provides comprehensive guidance for COVID-19 vaccine administration, including enrollment procedures, billing codes, and coverage details. COVID-19 vaccines are covered at no cost to members, with specific CPT codes for Pfizer-BioNTech (91300) and Moderna (91301) vaccines, and administration codes 0001A/0002A for first/second Pfizer doses and 0011A/0012A for Moderna doses.
Action Required
Immediately: Billing team must ensure COVID-19 vaccine claims use correct CPT codes (91300 for Pfizer, 91301 for Moderna) and administration codes (0001A/0002A for Pfizer first/second doses, 0011A/0012A for Moderna first/second doses). Update billing system to reflect no prior authorization required and no member cost-sharing. Providers must record vaccination details in system within 24 hours and local immunization registry within 72 hours.