MedicaidBilling CodesMedium impact
MAB2023012001
Pennsylvania Medicaid (DHS)·PA · Family Medicine, Internal Medicine, Pediatrics +2 more·Provider Bulletin
Effective date
Jan 20, 2023
We identified it
Jun 20, 2026
Summary
Pennsylvania Medical Assistance (Medicaid) added four new CPT codes for billing bivalent COVID-19 booster vaccines from Pfizer and Moderna, including pediatric formulations. All codes pay $40 per administration and are effective retroactively from August and October 2022.
Action Required
Immediately: Billing team must update fee schedules to include CPT codes 0124A, 0134A, 0144A, and 0154A for COVID-19 bivalent booster administration at $40 per dose for Pennsylvania Medicaid patients. Update billing system to use manufacturer-specific codes instead of generic vaccine codes. FQHCs and RHCs should bill T1015 for encounters and add vaccine codes on separate lines for tracking. Add M0201 for homebound patient administration.