skip to content
Thank you for visiting First Coast Service Options' Medicare provider website. This website is intended exclusively for Medicare providers and health care industry professionals to find the latest Medicare news and information affecting the provider community.
To enable us to present you with customized content that focuses on your area of interest, please select your preferences below:
Select which best describes you:
Select your location:
Select your line of business:
This website provides information and news about the Medicare program for health care professionals only. All communication and issues regarding your Medicare benefits are handled directly by Medicare and not through this website. For the most comprehensive experience, we encourage you to visit Medicare.gov or call 1-800-MEDICARE. In the event your provider fails to submit your Medicare claim, please view these resources for claim assistance.
En Español
Text Size:
Send a link to this page
[Multiple email adresses must be separated by a semicolon.]
Last Modified: 1/25/2021 Location: FL, PR, USVI Business: Part B

COVID-19 vaccine and monoclonal antibody billing for Part B providers

This article will assist Medicare Part B providers with proper billing relating to Coronavirus (COVID-19) vaccine and monoclonal antibody infusion. Beneficiary coinsurance and deductible are waived.

How to bill for COVID-19 vaccines and monoclonal antibodies

For billing single claims for COVID-19 vaccines and monoclonal antibodies, follow the instructions in the article below.
For roster billing and centralized billing refer to the Medicare billing for COVID-19 vaccine shot administration external link page.
When COVID-19 vaccine and monoclonal antibody doses are provided by the government without charge, only bill for the vaccine administration. Don't include the vaccine codes on the claim when the vaccines are free.
If the patient is enrolled in a Medicare Advantage (MA) plan, submit your COVID-19 vaccine and monoclonal antibody infusion claims to Original Medicare in 2020 and 2021.

COVID-19 vaccines and administration

Code
Description
Labeler name
Vaccine/procedure name
Effective date
Dosing interval
91300*
SARSCOV2 VAC 30MCG/0.3ML IM
Pfizer
Pfizer-Biontech Covid-19 Vaccine
12/11/2020
21 days
0001A
ADM SARSCOV2 30MCG/0.3ML 1ST
Pfizer
Pfizer-Biontech Covid-19 Vaccine Administration – First Dose
12/11/2020
21 days
0002A
ADM SARSCOV2 30MCG/0.3ML 2ND
Pfizer
Pfizer-Biontech Covid-19 Vaccine Administration – Second Dose
12/11/2020
21 days
91301*
SARSCOV2 VAC 100MCG/0.5ML IM
Moderna
Moderna Covid-19 Vaccine
12/18/2020
28 days
0011A
ADM SARSCOV2 100MCG/0.5ML1ST
Moderna
Moderna Covid-19 Vaccine Administration – First Dose
12/18/2020
28 days
0012A
ADM SARSCOV2 100MCG/0.5ML2ND
Moderna
Moderna Covid-19 Vaccine Administration – Second Dose
12/18/2020
28 days
91302*
SARSCOV2 VAC 5X10^10VP/.5MLIM
AstraZeneca
AstraZeneca Covid-19 Vaccine
TBD
28 days
0021A
ADM SARSCOV2 5X10^10VP/.5ML 1
AstraZeneca
AstraZeneca Covid-19 Vaccine Administration – First Dose
TBD
28 days
0022A
ADM SARSCOV2 5X10^10VP/.5ML 2
AstraZeneca
AstraZeneca Covid-19 Vaccine Administration – Second Dose
TBD
28 days
*Providers should not bill for the product if they received it for free.
Providers can submit claims using the following claim example:
Claim should include the proper billing of the ICD-10 in item 21:
Z23 - Encounter for immunization
Report the proper date of service
Report the proper place of service
Use the applicable CPT or HCPCs code:
0001A - Used for the first dose of Pfizer or 0011A for Moderna
0002A - Used for the second dose of Pfizer or 0012A for Moderna
The diagnosis pointer should be used to indicate the primary diagnosis on the claim form

Monoclonal antibodies and administration

Code
Description
Labeler name
Vaccine/procedure name
Effective date
Q0239*
bamlanivimab-xxxx
Eli Lilly
Injection, bamlanivimab, 700 mg
11/10/2020
M0239
bamlanivimab-xxxx infusion
Eli Lilly
Intravenous infusion, bamlanivimab-xxxx, includes infusion and post administration monitoring
11/10/2020
Q0243*
casirivimab and imdevimab
Regeneron
Injection, casirivimab and imdevimab, 2400 mg
11/21/2020
M0243
casirivi and imdevi infusion
Regeneron
Intravenous infusion, casirivimab and imdevimab includes infusion and post administration monitoring
11/21/2020
*Providers should not bill for the product if they received it for free.
Providers can submit claims using the following claim example:
Claim should include the proper billing of the ICD-10 in item 21:
Primary diagnosis of Z23, secondary diagnosis of U0071 as appropriate
Report the proper date of service
Report the proper place of service
Use the applicable CPT or HCPCs code:
M0239 for the Eli Lilly or M0243 for the Regeneron
The diagnosis pointer should be used to indicate the primary diagnosis on the claim form
Report the charge amount for each line item
Click here for information on billing these services through roster billing.

References

CDC: COVID-19 Vaccination Communication Toolkit external link for medical centers, clinics, and clinicians
FDA: COVID-19 Vaccines external link webpage
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.