Please note that providers may bill PacificSource for the administration of the vaccine, but not for the vaccine itself, which is paid for by the federal government. If you wish to bill for the vaccine as “reporting only,” you may do so by using a charge of $0.01.
To find the appropriate billing code for vaccine administration based on manufacturer, please refer to the following information:
Vaccine Code - 91300
Descriptor: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3 mL dosage, diluent reconstituted, for intramuscular use
Vaccine Administration Code(s): 0001A (1st dose), 0002A (2nd dose)
Vaccine Manufacturer: Pfizer, Inc
Vaccine Name: Pfizer-BioNTech COVID-19 Vaccine
NDC 10/NDC 11 Labeler Product ID (Vial): 59267-1000-1, 59267-1000-01
Dosing Interval: 21 days
Vaccine Code - 91301
Descriptor: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 100 mcg/0.5 mL dosage, diluent reconstituted, for intramuscular use
Vaccine Administration Code(s): 0011A (1st dose), 0012A (2nd dose)
Vaccine Manufacturer: Moderna, Inc
Vaccine Name: Moderna COVID-19 Vaccine
NDC 10/NDC 11 Labeler Product ID (Vial): 80777-273-10, 80777-0273-10
Dosing Interval: 28 days
Vaccine Code - 91302
Descriptor: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, DNA, spike protein, chimpanzee adenovirus Oxford 1 (ChAdOx1) vector, preservative free, 5x10 viral particles/0.5mL dosage, for intramuscular use
Vaccine Administration Code: 0022A (2nd dose)
Vaccine Manufacturer: AstraZeneca, Plc
Vaccine Name: AstraZeneca COVID-19 Vaccine
NDC 10/NDC 11 Labeler Product ID (Vial): 00310-1222-10
Dosing Interval: 28 days