MedicaidBilling CodesMedium impact
MAB2022060301
Pennsylvania Medicaid (DHS)·PA · Family Medicine, Internal Medicine, Pediatrics +2 more·Provider Bulletin
Effective date
Jan 3, 2022
We identified it
Jun 20, 2026
Summary
Pennsylvania Medical Assistance (Medicaid) added four new CPT codes (0051A, 0052A, 0053A, 0054A) to cover administration of ready-to-use Pfizer COVID-19 vaccines. These codes are specific to first, second, third, and booster doses and reimburse at $40.00 per administration.
Action Required
Immediately: Billing team must update Pennsylvania Medicaid billing to use the new CPT codes 0051A (first dose), 0052A (second dose), 0053A (third dose), and 0054A (booster dose) for Pfizer ready-to-use COVID-19 vaccine administration. Update fee schedules to reflect $40.00 reimbursement rate. For homebound patients, add code M0201 on same claim. FQHCs and RHCs must use T1015 for encounters and include vaccine codes on separate line for tracking.