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MedicaidBilling CodesMedium impact

MAB2020123001

Pennsylvania Medicaid (DHS)·PA · Pharmacy·Provider Bulletin
Effective date
Dec 1, 2020
We identified it
Jun 20, 2026
Days to comply

Summary

Pennsylvania Medical Assistance (Medicaid) will now reimburse pharmacies $10.00 for COVID-19 vaccine administration by licensed pharmacists. New specific procedure codes are established for Pfizer and Moderna vaccine administration billing.

Action Required

Action needed
Immediately: Update billing system to accept new COVID-19 vaccine administration codes 0001A, 0002A (Pfizer first/second dose) and 0011A, 0012A (Moderna first/second dose) for pharmacy services. Set reimbursement rate at $10.00 per administration. Use pharmacy NPI as billing/rendering provider and enrolled prescriber NPI in referring provider field. Submit claims via 837P format. Do not bill for vaccines received at no cost from federal government.