MedicaidBilling CodesHigh impact
COVID-19 Vaccination and Infusion Therapy Codes
Maryland Medicaid·MD · Allergy & Immunology, Pharmacy, Infectious Disease +4 more·Provider Transmittal
Effective date
Nov 16, 2020
We identified it
Jun 20, 2026
Summary
Maryland Medicaid MCOs must immediately implement billing codes and reimbursement rates for COVID-19 vaccination administration and bamlanivimab infusion therapy. Vaccination products and bamlanivimab are provided at no cost by the federal government; only administration costs are reimbursed. MCOs must reimburse at or above the specified FFS rates: $16.94 for initial vaccine dose, $28.39 for final dose, $22.81 for pharmacy administration, and $309.60 for bamlanivimab infusion.
Action Required
By November 16, 2020 (or immediately if this date has passed): (1) Billing team must add all eight COVID-19 vaccine and infusion therapy codes (91300, 91301, 0001A, 0002A, 0011A, 0012A, Q0239, M0239) to the billing system with corresponding FFS reimbursement rates. (2) Update system to process vaccine administration codes with first dose at $16.94 and second/final dose at $28.39 for physician billers; set pharmacy billers at $22.81 for both doses via Point of Sale System. (3) Configure bamlanivimab infusion code M0239 to reimburse at $309.60. (4) Providers must document that bamlanivimab is only administered in settings with immediate access to emergency medications and EMS capability. (5) Communicate to all contracted providers and pharmacy partners that claims for these services will be rejected if codes are not properly mapped or rates fall below FFS minimums. (6) MCOs must ensure system edits enforce that only product NDC codes paired with administration codes are accepted for reimbursement.