MedicaidBilling CodesMedium impact
MAB2022092801
Pennsylvania Medicaid (DHS)·PA · Family Medicine, Pediatrics, Pharmacy +1 more·Provider Bulletin
Effective date
Sep 28, 2022
We identified it
Jun 20, 2026
Summary
Pennsylvania Medical Assistance (Medicaid) has added new CPT codes for pediatric COVID-19 vaccines from Pfizer and Moderna. Ten new codes are now available for billing pediatric booster doses and primary series vaccines, with effective dates ranging from May 17, 2022 to June 17, 2022.
Action Required
Immediately: Billing team must update system to include new pediatric COVID-19 vaccine CPT codes 0074A, 0081A, 0082A, 0083A, 0091A, 0092A, 0093A, 0111A, 0112A, and 0113A for Pennsylvania Medicaid claims. FQHCs and RHCs should bill T1015 for encounters that include vaccine administration plus other services. Update encounter forms to specify age-appropriate vaccine codes for pediatric patients.