Are the CPT codes for the Janssen (Johnson & Johnson) COVID-19 vaccine now active?
Yes. CMS has updated its COVID-19 Vaccines and Monoclonal Antibodies website to indicate that the applicable Janssen COVID-19 vaccine CPT codes are retroactively effective back to 2/27/2021, the date the vaccine was granted its Emergency Use Authorization (EUA) by the FDA.
It is important to highlight that the CMS COVID-19 Vaccine website instruct providers not to bill for the vaccine product itself, CPT 91303, if the provider receives the vaccine at no cost. In these instances, providers would report the appropriate administration code only, CPT 0031A.
|Code||CPT Short Descriptor||Labeler Name||Vaccine/Procedure Name||Payment Allowance||Effective Dates|
|91303||SARSCOV2 VAC AD26 .5ML IM||Janssen||Janssen Covid-19 Vaccine||$0.010*||02/27/2021 – TBD|
|0031A||ADM SARSCOV2 VAC AD26 .5ML||Janssen||Janssen Covid-19 Vaccine Administration||$28.390**||02/27/2021 – TBD|
As always, we would caution there may be a delay for both MACs and commercial payers to update their respective claims processing systems to accept these new codes. We would advise confirming code availability with your respective payers prior to claim submission.
CMS COVID-19 Vaccines and Monoclonal Antibodies website: