MedicaidBilling CodesMedium impact
MAB2023032401
Pennsylvania Medicaid (DHS)·PA · Family Medicine, Internal Medicine, General Practice +1 more·Provider Bulletin
Effective date
Oct 19, 2022
We identified it
Jun 20, 2026
Summary
Pennsylvania Medical Assistance (Medicaid) has added CPT code 0044A to their fee schedule for administering Novavax COVID-19 booster shots, with a reimbursement rate of $40.00. This code has been effective since October 19, 2022, and applies to both fee-for-service and managed care Medicaid providers.
Action Required
Immediately: Billing team must update billing system to include CPT code 0044A for Novavax COVID-19 booster administration at $40.00 reimbursement rate for Pennsylvania Medicaid patients. Verify billing software can process this code for dates of service from October 19, 2022 forward. For homebound patients, bill M0201 alongside 0044A. FQHCs and RHCs should use T1015 when vaccine is given during a billable encounter.