COVID-19 Archives

COVID-19 Vaccine Pricing for 2026-2027

By Renee Dustman

In Billing

Sep 14th, 2026

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National payment allowances for COVID-19 vaccines given during the 2026-2027 season are now available. The Centers for Medicare & Medicaid Services (CMS) released the update on Sept. 1. Prices for the following COVID-19 vaccines are effective Aug. 27, 2026. CPT® Descriptor Product Payment 91304 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccin...

New Codes Describe TOFIDENCE for COVID-19 Hospital Treatment

By Renee Dustman

In Billing

May 1st, 2026

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The Centers for Medicare & Medicaid Services (CMS) has established one new billing code to describe TOFIDENCE (tocilizumab-bavi) when used to treat COVID-19 in hospitalized adults and two new administration codes. The new codes are effective July 1, 2026. Indications for Use TOFIDENCE — a biosimilar to ACTEMRA® (tocilizumab) — was approved in 2024 by ...

FDA Approves Updated mRNA COVID-19 Vaccine

By Lee Fifield

In COVID-19

Sep 4th, 2024

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The U.S. Food and Drug Administration (FDA) has approved and granted emergency use authorization for updated mRNA COVID-19 vaccines (2024-2025 formula) to include a monovalent (single) component that corresponds to the Omicron variant KP.2 strain of SARS-CoV-2. The updated formula more closely targets currently circulating variants and provides better protection against serious consequences of ...

PEMGARDA Receives Emergency Use Authorization

By Renee Dustman

In Billing

Apr 11th, 2024

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Two new codes allow providers to bill Medicare for the product and its administration. On March 22, the Centers for Medicare & Medicaid Services (CMS) added two new HCPCS level II codes for PEMGARDA™, an investigational monoclonal antibody product for the pre-exposure prophylaxis of COVID-19. Billing for PEMGARDA The product code is Q0224 Injection, pemivibart, ...

Get Paid for In-home Vaccines

By Guest Contributor

In Coding

Feb 5th, 2024

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The COVID-19 public health emergency is over but certain Medicare flexibilities continue. For calendar year (CY) 2024, the Centers for Medicare & Medicaid Services (CMS) finalized its proposal to maintain the additional Medicare Part B payment for in-home administration of the COVID-19 vaccine, as well as the pneumococcal, influenza, and hepatitis B vaccines. The additional ...