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Michigan Medicaid - MDHHSMedicaid · Billing Codes · Provider Bulletin · MIMedium impact

MSA 20-75

Effective date
Dec 1, 2020
Identified
Jun 20, 2026

Summary

Michigan Medicaid covers COVID-19 vaccine products and their administration for dates of service on or after December 1, 2020, and implementation is contingent on approval of a State Plan Amendment by CMS. During the public health emergency, Medicaid will not reimburse federally purchased or free vaccine products, so providers must bill the procedure code and the vaccine cost as $0.00, and vaccine administration is reimbursed at 100% of Medicare rates for equivalent services. New CPT codes 91300 (Pfizer) and 91301 (Moderna) identify the vaccine products, and administration codes 0001A and 0002A (Pfizer first and second dose) and 0011A and 0012A (Moderna first and second dose) identify the administration services.

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What to do

Action · 7 steps
01Already effective for dates of service on or after December 1, 2020: Billing team, bill the vaccine procedure code with the vaccine cost as $0.00, because Medicaid does not reimburse federally purchased or free vaccine products.
02Report the Pfizer product as 91300 and the Moderna product as 91301.
03Report administration with 0001A and 0002A for Pfizer first and second doses, and with 0011A and 0012A for Moderna first and second doses.
04Do not collect co-pays from beneficiaries for COVID-19 vaccine services.
05Federally qualified health centers, rural health clinics, tribal health centers and tribal FQHCs may be reimbursed for COVID-19 vaccine administration only when no other eligible qualifying clinic visit is provided on the same date of service, and all identifiable financial resources must be used for the administration before Medicaid funds.
06Medicaid enrolled providers seeking reimbursement for COVID-19 vaccine administration must be registered with the MDHHS Division of Immunization COVID-19 Vaccination Program, and registration questions go to MDHHS-COVIDVaccineProviders@michigan.gov.
07Pharmacies bill COVID-19 vaccine administration under existing policies at rates aligned with the practitioner fee screens.

Codes mentioned

9130091301

Original notice

MSA 20-75
michigan.gov · Always check the source before changing claims.
View original ↗

Related changes

See all Michigan Medicaid - MDHHS changes →
MMP 23-51: Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) Code UpdatesHighEffective Jul 1, 2023 · Claims & BillingMSA 20-65MediumEffective Oct 1, 2020 · Provider BulletinMMP 22-35MediumEffective Dec 1, 2022 · Provider BulletinBrowse every Michigan Medicaid - MDHHS change in the policy list

Related policy hubs

Michigan Medicaid - MDHHS policiesMI policy changesCode 91300Code 91301

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