November 2024
Updated COVID-19 vaccines approved by FDA
On Aug. 22, 2024, and Aug. 30, 2024, the U.S. Food and Drug Administration approved and authorized for emergency use updated mRNA COVID-19 vaccines from Moderna,** Novavax** and Pfizer-BioNTech.**
Use the following procedure codes for COVID-19 vaccine administration and products: *90480, *91304, *91318, *91319, *91320, *91321 and *91322.
Note: Previous COVID-19 vaccine administration and procedure codes have remained the same for the 2024-2025 COVID-19 vaccine formula.
For more information, see the following:
For commercial members
Updated 2024-25 COVID-19 vaccines have been added to Blue Cross Blue Shield of Michigan and Blue Care Network’s commercial Preventive Drug Coverage under the Patient Protection and Affordable Care Act.
The vaccine administration and products are part of our commercial members’ preventive benefits. For most health plans, there’s no member out-of-pocket cost. See below for information about checking vaccine benefits for Blue Cross and BCN commercial groups that may have out-of-pocket costs or may not have vaccine coverage.
Here’s how to check member eligibility and benefits for vaccines:
- Log in to our provider portal (availity.com).**
- Click on Patient Registration in the menu bar, and then click on Eligibility and Benefits Inquiry.
- Enter the payer information, and complete the fields in the Provider Information section.
- Complete the Patient Information section, and click on Search.
- Select the row for the appropriate member.
- In the Service Information section, enter Immunizations in the Benefit/Service Type field.
- Click on Submit.
- Do one of the following:
If… |
Then… |
There is a Benefit Explainer button near the top of the screen |
- Click on the Benefit Explainer button.
Tip: If Benefit Explainer doesn’t open, you’ll need to allow Availity Essentials™ to open pop-ups.
- In Benefit Explainer, click on the Search button.
- Press CTRL+F.
- Search Preventive Immunizations.
|
There isn’t a Benefit Explainer button near the top of the screen |
- Press CTRL+F.
- Search on Immunizations.
|
For Medicare Advantage members
Medicare Part B (medical benefit) covers COVID-19 vaccines at 100%. with no copay or deductible. The claims must be submitted under Part B. Follow the Centers for Medicare & Medicaid Services guidelines when submitting vaccine claims.
**Blue Cross Blue Shield of Michigan and Blue Care Network don’t own or control this website.
Availity® is an independent company that contracts with Blue Cross Blue Shield of Michigan and Blue Care Network to offer provider portal and electronic data interchange services.
None of the information included herein is intended to be legal advice and, as such, it remains the provider’s responsibility to ensure that all coding and documentation are done in accordance with all applicable state and federal laws and regulations. |