MedicaidBilling CodesMedium impact
MAB2023121101
Pennsylvania Medicaid (DHS)·PA · Family Medicine, General Practice, Internal Medicine +2 more·Provider Bulletin
Effective date
Dec 11, 2023
We identified it
Jun 20, 2026
Summary
Pennsylvania Medicaid updated CPT codes for COVID-19 vaccine administration effective September 11, 2023, replacing bivalent vaccine codes with new 2023-2024 formula codes (91318-91322 for Pfizer/Moderna, 91304 for Novavax), all reimbursed at $40.00. Previous bivalent codes were end-dated September 12, 2023.
Action Required
Immediately: Update billing system to use current COVID-19 vaccine administration codes 91318-91322 (Pfizer/Moderna) and 91304 (Novavax) for Pennsylvania Medicaid patients. Remove end-dated bivalent codes (0121A, 0151A, 0171A, 0172A, 0141A, 0142A) from active code lists. Verify all codes reimburse at $40.00. Train staff on manufacturer-specific code selection based on vaccine type administered.