MedicaidBilling CodesMedium impact
21-103 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 on COVID-19 vaccine administration, billing, and coverage for healthcare providers. COVID-19 vaccines are covered at no cost to members, with specific CPT codes for Pfizer-BioNTech (93100) and Moderna (91301) vaccines, and administration codes 0001A/0002A and 0011A/0012A respectively.
Action Required
Immediately: Billing team must ensure COVID-19 vaccine billing uses correct CPT codes - 93100 for Pfizer-BioNTech, 91301 for Moderna, with corresponding administration codes 0001A/0002A for Pfizer first/second doses and 0011A/0012A for Moderna first/second doses. Update billing system to reflect no patient cost-sharing for COVID-19 vaccines across all plan types. Record vaccination details in system within 24 hours and report to local immunization registry within 72 hours.