AMA Announces CPT Codes for Potential COVID-19 Boosters

The American Medical Association (AMA) has updated the Current Procedural Terminology (CPT) code set to include CPT codes for two COVID-19 booster candidates from Pfizer and Sanofi-GlaxoSmithKline (Sanofi-GSK).

The Pfizer booster is proposed for children between the ages of 5 and 11 years who have received their primary COVID-19 vaccine series. The Sanofi-GSK booster is proposed for people aged 18 years and older who have received their initial COVID-19 vaccine series.

While the booster candidates have yet to receive Emergency Use Authorization (EUA) from the FDA, AMA has published the CPT code updates to ensure that electronic systems and healthcare providers are prepared for potential authorization. The CPT codes will be effective for use only if the boosters receive EUA, the press release noted.

Individual CPT codes help distinguish between COVID-19 vaccines and dosing schedules to facilitate data-driven tracking, reporting, and analysis that supports healthcare professionals in allocating vaccines during the pandemic. So far, there are 35 CPT codes for reporting COVID-19 vaccines.

The administration CPT code for the Pfizer booster candidate is as follows:

0074A Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV- 2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 10 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation; booster dose

The product and administration CPT codes for the Sanofi-GSK booster candidate are as follows:

91310 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, monovalent, preservative free, 5 mcg/0.5 mL dosage, adjuvant AS03 emulsion, for intramuscular use

0104A Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, monovalent, preservative free, 5 mcg/0.5 mL dosage, adjuvant AS03 emulsion, booster dose

AMA offers a vaccine code finder resource to help identify the proper CPT code combination for specific types and doses of COVID-19 vaccines. Short, medium, and long descriptors for the CPT codes and other recent modifications are available on the AMA website.

The CPT Editorial Panel manages CPT code set changes and gathers input from healthcare stakeholders to ensure the CPT content reflects the coding demands of digital health, precision medicine, and other aspects of a modern healthcare system.

The new CPT codes for the COVID-19 boosters come as coronavirus cases continue to fluctuate across the country.

“As the highly contagious Omicron BA.2 coronavirus subvariant is causing an increase in COVID-19 infections across the country, the American Medical Association continues to strongly urge every eligible individual to make sure they are up to date on their COVID-19 vaccinations, including booster doses,” Gerald E. Harmon, MD, president of AMA, said in the press release.

Additionally, AMA has been a strong advocate for the COVID-19 vaccine mandate for healthcare workers. Back in July 2021, Susan R. Bailey, MD, immediate past president of AMA, urged all healthcare workers to get vaccinated against COVID-19 to protect patients and fellow colleagues.