COVID-19 Coding: Your Questions Answered

When the first COVID-19 vaccines were approved for emergency use by the Food and Drug Administration, it brought hope for the country and a slew of questions for patients and healthcare providers. As a service to our practice community, we’ve pulled together some information that can help your office get ahead of the curve when it comes to the COVID-19 vaccine.

Note that while the COVID-19 vaccine presents a lot of variables and challenges to administration, it also presents an opportunity for important personal connections during this difficult time. As healthcare professionals, you are in a unique position to offer reassurance, information, and a public health service to the community.

Now, let’s get to your questions.

Can my office be reimbursed for COVID-19 vaccine administration?

Yes. As part of the public health emergency phase, the federal government has made COVID-19 vaccines and boosters free to the public while allowing practices to bill for administration of the doses.

Your office will be able to bill a fee for the administration of each dose of the vaccine that will be paid by the patient’s private insurance, their public insurance, or by a Provider Relief Fund that has been set up for uninsured patients.

While originally there was a higher payment for the second dose of a COVID-19 vaccine, as of March 15, 2021, rates were set at $40 per each dose of the two-dose series and $40 for single-dose vaccinations, including boosters. Please check the CMS website for the most up-to-date rates.

How do I code for the administration of the COVID-19 vaccines?

Distinct codes have been provided for each vaccine manufacturer and for each dose. Unique coding of both vaccine and dose was set up to allow detailed tracking and reporting on the vaccine rollout as well as the efficacy of each particular vaccine by the AMA.

LINK: Find Your COVID-19 Vaccine CPT Codes at the AMA’s Website.

As with any new vaccines or administration codes, best practice is to review your payer contracts to ensure additional work is not required to add these CPT codes to your fee schedules.

How do I code for the administration of COVID-19 vaccines?

Distinct codes have been provided for each vaccine manufacturer and for each dose. Unique coding of both vaccine and dose was set up to allow detailed tracking and reporting on the vaccine rollout, as well as the efficacy of each particular vaccine, by the American Medical Association.

LINK: Find Your COVID-19 Vaccine CPT Codes at the AMA’s website.

As with any new vaccine or administration codes, best practice is to review your payer contracts to ensure additional work is not required to add these CPT codes to your fee schedules.

How do I store the COVID-19 vaccines?

Not all vaccines have the same storage requirements, so it’s important to make sure you understand the storage needs for each vaccine and how they relate to your office.

Pfizer-BioNTech COVID-19 Vaccine

Once a point of use (POU) receives a thermal shipper with our vaccine, they have multiple storage options:

• Ultra-low-temperature freezers, which are commercially available and can extend shelf life for up to six months.
• Pfizer thermal shippers, in which doses will arrive, can be used as temporary storage units for up to 30 days by refilling with dry ice every five days.
• Refrigeration units that are commonly available in hospitals and pharmacies. The vaccine can be stored for two weeks at temperatures between -25°C and -15°C.
• The vaccine can also be stored for up to one month (31 days) at temperatures between 2°C and 8°C.
• Once thawed and stored at temperatures between 2°C and 8°C, the vials cannot be refrozen or stored under frozen conditions.

For more details and information on storing the Pfizer-BiOnTech vaccine, see its COVID-19 Vaccine U.S. Distribution Fact Sheet.

Moderna COVID-19 Vaccine

Moderna’s COVID-19 vaccine will arrive frozen at temperatures between -50°C and -15°C (-58°F and 5°F). They can remain frozen until their expiration date.

Vaccines should be thawed in preparation for use. A POU can:

• Thaw in a refrigerator from 2°C to 8°C (36°F and 40°F). 5.5 mL vials should be thawed for 2.5 hours, while 7.5 mL vials should be thawed for 3 hours. Vials should then sit at room temperature for 15 minutes immediately before use.
• Thaw vials at room temperature between 15°C and 25°C (59°F and 77°F). 5.5 mL vials should be thawed for 1 hour, while 7.5 mL vials should be thawed for 1.5 hours.
• Vaccines should not be stored on dry ice or below -50ºC (-58ºF) and should remain in the original carton to protect from light.

After vaccines are thawed in preparation for use, they can then be stored at the following times at the following temperatures:

Unpunctured vials:

• 30 days: refrigerated at 2º-8ºC (36º-46ºF)
• 24 hours: cool storage up to room temperature at  8º-25ºC (46º-=77ºF)

After the first dose has been withdrawn:

• 12 hours: cool storage up to room temperature as defined as 2º-25ºC (36º-77ºF). Record the date and time of first use on the vial label. Discard punctured vial after 12 hours.

Thawed vials of vaccine cannot be refrozen.

For more details and information on storing the Moderna vaccine, see its Storage & Handling Guide.

JNJ-78436735 COVID-19 Vaccine

The COVID-19 vaccine from Johnson & Johnson differs from the Moderna and Pfizer vaccines in one key way that impacts storage. Where both Moderna and Pfizer have based their vaccines on mRNA technology, the JNJ vaccine is based on double-stranded DNA technology (similar to the Ebola vaccine approved in July 2020). The DNA is delivered inside a modified adenovirus, and these two elements together make it a more “rugged” vaccine than the mRNA-based Pfizer and Moderna vaccines. As such, the refrigeration requirements are not as demanding. 

• The vaccines arrive in a 2°-8°C (36°-46°F) qualified shipping container.
• Unpunctured vials can be stored between 2°C and 8°C (36°F and 46°F) until their expiration date. ‚ 
• Punctured vials can be stored between 2°C and 8°C (36°F and 46°F) for up to 6 hours. Note the date and time the vial was first punctured. Discard vaccines not used within this time. 
• Vials should not be frozen or exposed to light.

For more details and information on storing the Johnson & Johnson vaccine, see its Storage & Handling Summary.

Need help managing your COVID-19 vaccinations?

Our COVID-19 Assist program can help you manage, track, and bill for immunizations you administer, easing the burden on your practice and giving you a better view into your patients’ COVID-19 immunization stats. Tools such as our Mobile Hub and Event Registration App can also bring greater flexibility and ease to vaccinating your community. Get in touch to learn more!