Use Medical Codes and Forms to Expedite COVID-19 Vaccine Claims

  • May 6, 2021

    If your dental practice is offering COVID-19 vaccines, there are some things you should know about submitting claims, including:

    • There are specific CPT medical COVID-19 vaccine codes that vary by drug brand and the applicable dose.  See the table below for details.
    • The ADA also created dental codes for administering the vaccine.
    • Using the medical codes and medical form for COVID-19 vaccine administration can expedite Premera’s processing of your claims, however the dental form with dental codes can be used. 
    • For more information about COVID-19 related claims and testing, including medical and dental codes, refer to our COVID-19 FAQ.

    COVID-19 Vaccine codes (medical)

    Code Description
    91300
    (Pfizer Vaccine)

    Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (Coronavirus disease [COVID-19]) vaccine, mRNALNP, spike protein, preservative free, 30 mcg/0.3mL dosage, diluent reconstituted, for intramuscular use

    (Report with administration codes: 0001A-First administration and 0002A-Second administration). Eff. 12/11/2020
    0001A
    (Admin1)    		 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, 30 mcg/0.3mL dosage, diluent reconstituted; first dose. (Report with administration of Pfizer vaccine 91300)
    0002A
    (Admin2)    		 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, 30 mcg/0.3mL dosage, diluent reconstituted; second dose. (Report with administration of Pfizer vaccine 91300)
    91301
    (Moderna Vaccine)

    Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (Coronavirus disease [COVID-19]) vaccine, mRNALNP, spike protein, preservative free, 100 mcg/0.5mL dosage, for intramuscular use

    (Report with administration codes: 0011A-First administration and 0012A-Second administration) Eff. 12/18/2020
    0011A
    (Admin1)    		 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, 100 mcg/0.5mL dosage; first dose. (Report with administration of Moderna vaccine 91301)
    0012A
    (Admin2)    		 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, 100 mcg/0.5mL dosage; second dose. (Report with administration of Moderna vaccine 91301)
    91303
    (Janssen /Johnson & Johnson Vaccine)    		 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, DNA, spike protein, adenovirus type 26 (Ad26) vector, preservative free, 5x1010 viral particles/0.5mL dosage, for intramuscular use. Eff. Date: 2/27/2021
    0031A Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, DNA, spike protein, adenovirus type 26 (Ad26) vector, preservative free, 5x1010 viral particles/0.5mL dosage, single dose. Eff. Date: 2/27/2021

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