MedicaidBilling CodesMedium impact
MAB2022101701
Pennsylvania Medicaid (DHS)·PA · Family Medicine, Internal Medicine, Pediatrics +2 more·Provider Bulletin
Effective date
Mar 29, 2022
We identified it
Jun 20, 2026
Summary
Pennsylvania Medical Assistance (Medicaid) added CPT code 0094A for billing administration of Moderna COVID-19 booster doses, with a $40.00 reimbursement rate. This code is effective for dates of service on and after March 29, 2022, and applies to both fee-for-service and managed care delivery systems.
Action Required
Immediately: Update billing system to include CPT code 0094A for Moderna COVID-19 booster administration with $40.00 rate for PA Medicaid patients. Train staff to use M0201 modifier for homebound patients receiving boosters. FQHCs and RHCs must bill T1015 for encounters that include vaccines plus 0094A on separate line for tracking.