MedicaidBilling CodesMedium impact
MAB2021031201
Pennsylvania Medicaid (DHS)·PA · Family Medicine, Internal Medicine, Pediatrics +1 more·Provider Bulletin
Effective date
Feb 27, 2021
We identified it
Jun 20, 2026
Summary
Pennsylvania Medical Assistance program added new CPT code 0031A for administering the Janssen COVID-19 vaccine (J&J single-dose vaccine) with a reimbursement rate of $28.39. This code is effective for dates of service February 27, 2021 and later.
Action Required
Immediately: Billing team must add CPT code 0031A to billing system for Janssen COVID-19 vaccine administration with reimbursement rate of $28.39. Update encounter forms and provider documentation to specify Janssen vaccine type. Ensure billing limit of once per day is configured. Note: Do not bill for vaccines received at no cost from federal government.