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Ask a Rev Cycle Expert: APC for New Code?


What is the APC for CPT® code 0074A? I have been unable to locate this when searching for information.


Current Procedural Terminology (CPT®) code 0074A 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; booster dose has not yet been given approval nor an emergency use authorization (EUA) by the U.S. Food & Drug Administration (FDA). At this time, the code has not been assigned to an Ambulatory Payment Classification (APC) because it is not yet reimbursable. Other COVID-19 booster doses have been assigned to APC 9398

COVID-19 Vaccine Admin Dose 2 of 2, Single Dose Product or Additional Dose with a national payment rate of $40, and it may be anticipated that CPT® code 0074A will be assigned to this APC after receiving the EUA.

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