Additional doses and boosters: COVID-19 vaccine billing

NCPA October 22, 2021

With the Centers for Disease Control and Prevention’s announcement on coronavirus booster shots, it’s especially important for pharmacies to accurately code claims for COVID-19 vaccines. Use information collected on your vaccine screening form to determine if you will administer an additional dose or a booster dose. The CDC recommends that certain patients who are moderately to severely immune compromised receive an additional dose; for these doses use Submission Clarification Code (SCC) – 07. Claims for booster doses administered to eligible patients should be submitted after the authorized interval for the liquid volume authorized for the product; for these doses use SCC – 10 (some PBMs may temporarily require SCC 7 and SCC 10 to be submitted together). For more COVID-19 vaccine billing information click here or email covid@ncpa.org.

NCPA