Billing codes for boosters

NCPA September 21, 2021

NCPA has updated the vaccine billing handout for members with the info you need to bill COVID-19 boosters. The update to the NCPDP guidance hasn’t been published yet (current version here; see Section 10), but is expected to recommend that claims for COVID-19 boosters use Submission Clarification Code (SCC) 10. Some PBMs may temporarily require SCC 07 and SCC 10 to be submitted together which allows them to process claims immediately and avoid having to reject claims in this fluid situation. Email with questions.