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Are the CPT codes for the Pfizer pediatric COVID-19 vaccine now active?

Yes. On November 4, 2021, CMS issued the MLN article linked below, confirming Medicare will cover the Pfizer pediatric COVID-19 vaccine for children ages 5-11. CMS has updated its COVID-19 Vaccines and Monoclonal Antibodies homepage to reflect that CPTs 91307, 0071A and 0072A are retroactively effective back to 10/29/21 – the date the FDA issued its Emergency Use Authorization for the pediatric formulation. For your convenience, we have included the full long descriptions for the relevant codes below.

91307: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 10 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation, for intramuscular use

0071A: Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 10 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation; first dose

0072A: Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 10 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation; second dose

CPT code 91307 represents the pediatric Pfizer COVID-19 vaccine product, CPT 0071A is reported for the first administration service and CPT 0072A is reported for the second dose administration service. Additional clinical information regarding administration of the vaccine can be found in the FDA press release also provided below.

CMS MLN Connects, “COVID-19: Changes for Medicare Advantage Plan Claims Starting January 1”:
https://www.cms.gov/outreach-and-educationoutreachffsprovpartprogprovider-partnership-email-archive/2021-11-04-mlnc

CMS COVID-19 Vaccines and Monoclonal Antibodies homepage:
https://www.cms.gov/medicare/medicare-part-b-drug-average-sales-price/covid-19-vaccines-and-monoclonal-antibodies

FDA press release, “FDA Authorizes Pfizer-BioNTech COVID-19 Vaccine for Emergency Use in Children 5 through 11 Years of Age”:
https://www.fda.gov/news-events/press-announcements/fda-authorizes-pfizer-biontech-covid-19-vaccine-emergency-use-children-5-through-11-years-age

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