MedicaidBilling CodesHigh impact
COVID-19 Vaccine Administration Reimbursement
Maryland Medicaid·MD·Provider Transmittal
Effective date
Feb 1, 2021
We identified it
Jun 20, 2026
Summary
Maryland Medicaid will reimburse FQHCs for COVID-19 vaccine administration at Fee-for-Service rates when vaccination is the sole purpose of the visit, effective February 1, 2021. Four specific CPT codes (0001A, 0002A, 0011A, 0012A) are approved for Pfizer and Moderna vaccines at rates ranging from $16.94 to $28.39. When vaccination occurs during a somatic office visit, it must be included in the cost-based rate and not billed separately.
Action Required
By February 1, 2021: Billing team must update billing software to recognize CPT codes 0001A, 0002A, 0011A, and 0012A with the specified FFS reimbursement rates ($16.94 for first doses, $28.39 for second doses). Establish billing logic to allow standalone billing ONLY when COVID-19 vaccination is the sole purpose of the visit. When vaccination occurs during a somatic office visit, configure system to include administration in the cost-based visit rate and prevent separate billing. Train billing and front desk staff on the distinction between standalone vaccination visits (billable) versus vaccination during routine office visits (bundled). Update encounter forms and provider documentation templates to capture whether the visit is solely for vaccination or includes other clinical services. Failure to implement these changes will result in claim denials for improperly billed vaccine administration.