Providers that participate in the Centers for Disease Control and Prevention (CDC) COVID-19 Vaccination Program contractually agree to administer a COVID-19 vaccine regardless of an individual’s ability to pay and regardless of their coverage status, and also may not seek any reimbursement, including through balance billing, from a vaccine recipient.
All vaccines must receive Emergency Use Authorization (EUA) or approval from the U.S. Food and Drug Administration (FDA) before they can be distributed to the public.
- EUAs can be used by the FDA during public health emergencies to provide access to medical products that may be effective in preventing, diagnosing or treating a disease, provided that the FDA determines that the known and potential benefits of a product, when used to prevent, diagnose or treat the disease, outweigh the known and potential risks of the product.
- FDA-approved vaccines undergo the agency’s standard process for reviewing the quality, safety and effectiveness of medical products.
View the FDA's website for information about authorizations and approvals.
Vaccine administration | Providers need to submit claims to Asuris for reimbursement of the vaccine administration. We will cover the administration fees per the member’s benefit. Administration fees will need to be billed based on the codes assigned to the manufacturer’s vaccine. Note: Retail pharmacies can file vaccine claims under the medical or pharmacy benefits for commercial members. | |
Vaccine | Claims for COVID-19 Vaccines (drugs) received at no cost to the provider do not need to be submitted to Asuris. However, if required by your claim system, the vaccine can be included in the non-covered services column on the administration claim submitted to Asuris. | |
Vaccine administration | Providers need to submit claims to Asuris for reimbursement of the vaccine administration. Note: For Medicare Advantage members, if providers submit vaccine-related claims to Original Medicare for dates of service on or after January 1, 2022, the system will deny the claim and advise the provider to file to Asuris. | |
Vaccine | Claims for COVID-19 Vaccines (drugs) received at no cost to the provider do not need to be submitted to Asuris. However, if required by your claim system, the vaccine can be included in the non-covered services column on the administration claim submitted to Asuris. | |
The American Medical Association (AMA), Centers for Medicare & Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC) collaborated to establish Current Procedural Terminology (CPT) codes and reimbursement for the COVID-19 vaccines, as well as the administration.
View all COVID-19 updates and resources.