COVID-19 Vaccine Information for Providers
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Providers

COVID-19 Vaccine Information for Providers

May 24, 2021

New: All members who are over the age of 12 are now eligible to get the COVID-19 Vaccine in Oregon. For more information, please visit  Oregon’s vaccine news page. You can also check out  OHA’s frequently asked questions about the COVID-19 vaccine for 12 to 17-year-olds.

Thank you for your continued efforts to deliver quality care to EOCCO members. Since there are many updates regarding the COVID-19 Vaccine, we hope to keep you informed as much as possible, so you can focus on serving your patients. Please note that the details below are subject to change as the Oregon Health Authority (OHA) releases updated information. Providers are encouraged to check this page frequently.

Below are some important notes to highlight regarding the COVID-19 Vaccine:

  1. COVID-19 Vaccine Administration Period
    1. The vaccine administration began on December 15th 2020. EOCCO will communicate the end date of the Vaccine Administration Period as soon as OHA announces this information.
    2. The COVID-19 Vaccine must be administered during the COVID-19 Vaccine Administration Period.
  2. Provider enrollment with OHA
    1. EOCCO members can receive the COVID-19 Vaccine from any provider that is enrolled as a Medicaid Provider with OHA. If the Provider is not a Participating Provider with EOCCO, the Provider must bill OHA directly for expenses of administering COVID-19 Vaccine which will be paid under Oregon’s Fee-for-Service program.
  3. Enrolling as a COVID-19 Vaccine Provider
    1. Please see this OHA document for more information regarding the COVID-19 Provider Enrollment Process.
    2. You can also visit OHA’s COVID-19 Healthcare Partner resources page.
      1. Click on “Provider Enrollment and Planning” under the “Pandemic Resources” section.
  4. Prior Authorizations
    1. Prior Authorizations are not required for the COVID-19 Vaccine.
  5. COVID-19 Billing & Reimbursement
    1. If the Provider is not a Participating Provider with EOCCO, the Provider must bill OHA directly for expenses of administering COVID-19 Vaccine which will be paid under Oregon’s Fee-for-Service program

 

 

Code

Descriptions

Modifier

Rates

Through

3/14/2021

On or after

3/15/2021

001A

Pfizer-Biontech Covid-19 Vaccine Administration – First Dose

CR

$16.94

$40.00

002A

Pfizer-Biontech Covid-19 Vaccine Administration – Second Dose

CR

$28.39

$40.00

0011A

Moderna Covid-19 Vaccine Administration – First Dose

CR

$16.94

$40.00

0012A

Moderna Covid-19 Vaccine Administration – Second Dose

CR

$28.39

$40.00

0031A

Johnson & Johnson – Janssen COVID-19 Vaccine – Single Dose

CR

$28.39

$40.00

 

 

Additional resources from OHA regarding vaccine billing, sequencing, and other information can be found in following links: