Coding for Reimbursement

Commercial

How are you billing?

Pharmacists using the NCPDP format should use the appropriate NDC and units for the vaccine administered.

Based on your inputs:
  1. Moderna COVID-19 Vaccine (6 months - 11 years)
  2. Commercial
  3. Pharmacy benefit
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NDC Codes

Moderna COVID-19 Vaccine 2024-2025 Formula 25mcg/.25mL (6mos-11 years)

80777-291-09

NOTES:

The Billing Unit (BU) is a milliter (mL) for the individual vaccine product with the quantity of the number of units dispensed.

  • The Moderna pediatric COVID-19 Vaccine, mRNA for 6 months -11 years of age is billed with 0.25mL.

Remember to bill for the administration service if performed.

Additional Codes

CVX

CVX CODE:
311

CVX DESCRIPTOR:
  • SARS-COV-2 (COVID-19) vaccine, mRNA, spike protein, LNP, preservative free, 25 mcg/0.25 mL dose.
  • Used for registries as required.

For more details, visit our Frequently Asked Questions page.

Please see the Spikevax® 2024-2025 Formula Prescribing Information and the Moderna COVID-19 Vaccine (2024-2025 Formula) Fact Sheets for more information.

Spikevax 2024-2025 Formula Prescribing Information 12y

Moderna COVID-19 Vaccine 2024-2025 Formula Fact Sheet for Vaccine Providers 6m-11y

Moderna COVID-19 Vaccine 2024-2025 Formula Fact Sheet for Vaccine Recipients 6m-11y

The coding and billing information contained in this digital tool is provided as a resource and every effort is made to ensure the accuracy of this information. Appropriate coding and billing for healthcare services are theprovider's responsibility and should always be based on the patient's clinical condition, services provided, and current payer guidelines