Ask a Rev Cycle Expert: CPT® 0031A Reimbursement?
Question:
Is there reimbursement information for CPT® code 0031A IMM ADMN SARSCOV2 AD26 5X1010 VP/0.5 ML 1 DOSE?
Answer:
Because the Janssen Pharmaceutical (parent company: Johnson & Johnson) vaccine is a single dose, the Centers for Medicare & Medicaid Services (CMS) has indicated the reimbursement rate of $28.390 on their COVID-19 Vaccines and Monoclonal Antibodies page, with an effective date of February 27, 2021. The rate has yet to be posted in the Addendum A & B pricing files, but we are in the process of adding the information to the Code Lookup module.
https://www.cms.gov/medicare/medicare-part-b-drug-average-sales-price/covid-19-vaccines-and-monoclonal-antibodies
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