COVID-19 Vaccines Payment Allowance Updates

As vaccines become more and more available, CMS has released a payment allowance and effective dates cheat sheet to assist providers, states and insurers prepare to administer COVID-19 vaccines swiftly. Below is a quick overview of the CMS cheat sheet.

CPT Code – 91300

• Payment Allowance $0.010 (previously $0.010)
• Effective Dates 12/11/2020 – TBD

CPT Code – 0001A

• Payment Allowance $40.000 (previously $16.940)
• Effective Dates 12/11/2020 – TBD

CPT Code – 0002A

• Payment Allowance $40.000 (previously $28.390)
• Effective Dates 12/11/2020 – TBD

CPT Code – 91301

• Payment Allowance $0.010 (previously $0.010)
• Effective Dates 12/18/2020 – TBD

CPT Code – 0011A

• Payment Allowance $40.000 (previously $16.940)
• Effective Dates 12/18/2020 – TBD

CPT Code – 0012A

• Payment Allowance $40.000 (previously $28.390)
• Effective Dates 12/18/2020 – TBD

CPT Code – 91302

• Payment Allowance $0.010 (previously $0.010)
• Effective Dates – TBD

CPT Code – 0021A

• Payment Allowance $40.000 (previously $16.940)
• Effective Dates – TBD

CPT Code – 0022A

• Payment Allowance $40.000 (previously $28.390)
• Effective Dates – TBD

CPT Code – 91303

• Payment Allowance $0.010 (previously $0.010)
• Effective Dates 02/27/2020 – TBD

CPT Code – 0031A

• Payment Allowance $40.000 (previously $28.390)
• Effective Dates 02/27/2020 – TBD

For a full breakdown provided by CMS please visit cms.gov page here: https://www.cms.gov/medicare/medicare-part-b-drug-average-sales-price/covid-19-vaccines-and-monoclonal-antibodies

Sources: CMS