MedicaidBilling CodesMedium impact
MAB2022060302
Pennsylvania Medicaid (DHS)·PA · Family Medicine, Pediatrics, Internal Medicine +2 more·Provider Bulletin
Effective date
Jan 3, 2022
We identified it
Jun 20, 2026
Summary
Pennsylvania Medical Assistance (Medicaid) has added CPT code 0073A to their fee schedule for billing the third dose of Pfizer's pediatric COVID-19 vaccine. The code is reimbursed at $40.00 and can be billed for dates of service on or after January 3, 2022.
Action Required
Immediately: Update billing system to include CPT code 0073A for third dose Pfizer pediatric COVID-19 vaccine administration with $40.00 reimbursement rate for Pennsylvania Medicaid patients. For homebound patients, bill M0201 along with 0073A. FQHCs and RHCs should bill T1015 for encounters and 0073A separately for tracking when vaccine is given during other services.