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COVID-19 Vaccines

WellCare is closely following advancements in the prevention and treatment of COVID-19. As a healthcare provider, you will play an integral role in the COVID-19 vaccine process.

Similar to other COVID-19 services, the vaccines will be offered at no cost to your patients. In addition:

  • WellCare will configure its systems to properly adjudicate COVID-19 vaccine-related administration claims in accordance Florida’s coverage determinations for Medicaid beneficiaries
  • Member liability will be $0
  • No prescription or prior authorization is needed for all provider types, regardless of network status
  • Provider reimbursement rates and emergency use authorizations (EUA) are all still pending and we will update you as that information becomes available

The American Medical Association published vaccine-specific CPT codes to report immunizations for COVID-19, and CMS published billing guidance for Medicaid and CHIP providers. CMS also has published a set of toolkits to help providers swiftly administer the vaccine.

Medicaid-enrolled provider types that are eligible to provide the vaccine (must have a Medicaid ID) include: physicians, extenders, pharmacies (via pharmacists), Federally Qualified Health Centers, rural health clinics and county health departments.

All providers administering COVID vaccines must be enrolled in the federal COVID-19 vaccine program. Providers must report COVID vaccinations in SHOTS. The Pfizer vaccine is currently only approved for ages 16 and up. The Moderna vaccine is approved for ages 18 and up.

Code

CPT Short Descriptor

Labeler Name

Vaccine/Procedure Name

91300

SARSCOV2 VAC

30MCG/0.3ML IM

Pfizer

Pfizer-Biotech Covid-19 Vaccine

0001A

ADM SARSCOV2 VAC

30MCG/0.3ML 1ST

Pfizer

Pfizer-Biotech Covid-19 Vaccine

Administration – First Dose

0002A

ADM SARSCOV2 VAC

30MCG/0.3ML 2ND

Pfizer

Pfizer-Biotech Covid-19 Vaccine

Administration – Second Dose

91301

SARSCOV2 VAC

100MCG/0.5ML IM

Moderna

Moderna Covid-19 Vaccine

0011A

ADM SARSCOV2 VAC

100MCG/0.5ML 1ST

Moderna

Moderna Covid-19 Vaccine

Administration – First Dose

0012A

ADM SARSCOV2 VAC

100MCG/0.5ML 2ND

Moderna

Moderna Covid-19 Vaccine

Administration – Second Dose

This list will be updated as additional vaccines become available.

If you have any further questions please contact Provider Services at 1-866-334-7927

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Y0070_WCM_42183E Last Updated On: 12/23/2020