Posted Feb 03, 2025
As of May 11, 2023, the COVID-19 Public Health Emergency (PHE) has ended. Providers billing for COVID-19 should be aware of the below changes.
A printable PDF is available here.
Starting October 1, 2024, COVID-19 vaccines will follow standard billing guidance for routine vaccinations for all ages. Reimbursement will align with current procedure codes and fee schedules.
For Medicaid Members 19 years and older, providers should use CPT code 90480 when administering the COVID-19 vaccine.
Starting January 1, 2025, NYS Medicaid will revert to pre-pandemic vaccine processing for Medicaid members under 19 years of age. Pharmacy providers administering COVID-19 vaccines to VFC-eligible members must be enrolled in the VFC program.
If you have questions around Medicaid Pharmacy Policies, contact NYRx at 1-518-486-3209 or NYRx@health.ny.gov. For any other questions, contact your Network Account Manager or call Provider Services at 1-888-801-1660, Monday to Friday, 8:30am–5:30pm.