MedicaidBilling CodesMedium impact
MAB2021090112
Pennsylvania Medicaid (DHS)·PA · Family Medicine, Internal Medicine, General Practice +2 more·Provider Bulletin
Effective date
Aug 12, 2021
We identified it
Jun 20, 2026
Summary
Pennsylvania Medical Assistance (Medicaid) added two new CPT codes (0003A and 0013A) for billing third-dose COVID-19 vaccine administration by Pfizer and Moderna respectively. These codes are effective for services on or after August 12, 2021, with a reimbursement rate of $40.00 per administration.
Action Required
Immediately: Billing team must add CPT codes 0003A (Pfizer third dose) and 0013A (Moderna third dose) to billing system for Pennsylvania Medicaid patients receiving COVID-19 vaccine boosters. Set reimbursement rate at $40.00 and configure once-per-day limit. Update encounter forms to include these new codes for vaccine administration tracking.