MedicaidBilling CodesLow impact
MAB2022091901
Pennsylvania Medicaid (DHS)·PA · Family Medicine, Internal Medicine, Pediatrics +2 more·Provider Bulletin
Effective date
Jul 13, 2022
We identified it
Jun 20, 2026
Summary
Pennsylvania Medicaid has added two new CPT codes (0041A and 0042A) for billing the administration of Novavax COVID-19 vaccines to Medical Assistance beneficiaries. These codes are specific to the Novavax vaccine and must be used to track first and second dose administrations.
Action Required
Immediately: Billing team must update system to include CPT codes 0041A (Novavax first dose) and 0042A (Novavax second dose) for Pennsylvania Medicaid patients. Verify fee schedule shows $40.00 reimbursement for each code. For homebound patients, bill M0201 along with the vaccine code. FQHCs and RHCs should use T1015 when vaccine is given during an encounter.