COVID-19 CPT vaccine and immunization codes

New Current Procedural Terminology (CPT^®) codes have been created that consolidate over 50 previous codes and greatly streamline the reporting of immunizations for the novel coronavirus (SARS-CoV-2, also known as COVID-19).

The CPT Editorial Panel approved five new COVID-19 vaccine product codes and one administration code in August 2023. These new COVID-19 codes replaced all previously approved specific COVID-19 product and administration codes, except for vaccine product code 91304for the Novavax vaccine.

Specific information to assist with proper code selection of the more than 50 COVID-related vaccine product and administration codes were contained in Appendix Q of the CPT code set. With the removal of those COVID-19 codes, Appendix Q was also deleted in November.

Some vaccine and immune globulin products are assigned a code in anticipation of eventual approval by the Food and Drug Administration. These codes are marked with a lightning bolt symbol in the Category I Immunization code descriptors (PDF).

The new codes added for 2024 include three Pfizer-product codes and reflect vaccine concentrations developed for different age groups:

• 91318: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, 3 mcg/0.2 mL dosage, diluent reconstituted, tris-sucrose formulation, for intramuscular use  in patients 6 months–4 years old.
• 91319: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, 10 mcg/0.2 mL dosage, tris-sucrose formulation, for intramuscular use in patients 5–11 years old.
• 91320: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, 30 mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular use in patients 12 years and older.

There are also two new Moderna-product codes: 

• 91321: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, 25 mcg/0.25 mL dosage, for intramuscular use in patients 6 months–11 years old.
• 91322: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, 50 mcg/0.5 mL dosage, for intramuscular use was associated for use in patients 12 years or older.

The existing CPT code 91304 will continue to be used to report the Novavax vaccine product, including Novavax’s updated XBB vaccine:

• 91304: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, recombinant spike protein nanoparticle, saponinbased adjuvant, 5 mcg/0.5 mL dosage, for intramuscular use.

All existing CPT codes that describe COVID-19 vaccine products and associated administration codes that end in “A” for products that are no longer covered under an existing Emergency Use Authorization (EUA) or Biologics License Application (BLA) from the US Food and Drug Administration (FDA) will be deleted effective Nov. 1, 2023.

To view the updated SARS-CoV-2-related CPT codes approved by the CPT Editorial Panel, please visit the Category I immunizations page.

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• COVID-19 CPT vaccine and immunization codes
• COVID-19 CPT coding and guidance

The CPT “vaccine early release schedule” is now known as the “immunization early release” schedule and includes vaccines/toxoids, immune globulins and serum or recombinant products.

Two new seasonal RSV monoclonal antibody immunization pediatric codes for children less than 24 months of age with dosage based on the child’s weight were created, as well as two new administration codes for these products that are differentiated by the inclusion of counseling:

• 90380: Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 mL dosage, for intramuscular use.
• 90381: Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 mL dosage, for intramuscular use.
• 96380: Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection, with counseling by physician or other qualified health care professional.
• 96381: Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection.

Additionally, three vaccine codes were created and associated with use in the adult population:

• 90678: Respiratory syncytial virus vaccine, preF, subunit, bivalent, for intramuscular use  is associated with adults 60 years and older, plus pregnant patients at 32–36 weeks gestation.
• 90679: Respiratory syncytial virus vaccine, preF, recombinant, subunit, adjuvanted, for intramuscular use is associated with use in adults 60 years and older.
• 90683: Respiratory syncytial virus vaccine, mRNA lipid nanoparticles, for intramuscular use is an mRNA product associated with use in adults 60 years and older.

These codes were developed to provide better tracking to support data-driven planning and allocation, and to track patient outcomes.

Also new are:

• 90589: Chikungunya virus vaccine, live attenuated, for intramuscular use.
• 90623: Meningococcal pentavalent vaccine, conjugated Men A, C, W, Y- tetanus toxoid carrier, and Men B-FHbp, for intramuscular use.