COVID-19: Updated Novavax COVID-19 Vaccine, Adjuvanted for Patients 12 & Older

This updated, monovalent vaccine:

• Addresses currently circulating variants to provide better protection against serious consequences of COVID-19, including hospitalization and death
• Includes the spike protein from the SARS-CoV-2 omicron variant lineage XBB.1.5

Updated payment allowance effective October 3, 2023:

CMS updated the national payment allowance to $148.20 for CPT code 91304 – Novavax Covid-19 Vaccine, Adjuvanted (Aged 12 years and older).

The federal government isn’t purchasing these products. Medicare Part B pays for the drug and its administration under the applicable Medicare Part B payment policy.

Use CPT code 90480 to bill for the administration of the vaccine. Get the most current list of billing codes, including short descriptors, payment allowances, and effective dates.

Medicare no longer pays for CPT codes 0041A, 0042A, and 0044A effective October 3, 2023.

Visit the COVID-19 Vaccine Provider Toolkit for more information.