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COVID-19 Booster Billing Codes Issued

The National Community Pharmacists Association (NCPA) has updated its COVID-19 vaccine billing and reimbursement handout to reflect the changes in the National Council for Prescription Drug Programs' (NCPDP) emergency preparedness guidance for COVID-19 booster claims. NCPDP guidance recommends COVID-19 booster claims use Submission Clarification Code (SCC) 10 with some PBMs requiring both SCC 07 (third dose for targeted populations) and SCC 10 to be submitted together.


This update follows the recent Pfizer-BioNTech COVID-19 Vaccine booster recommendations provided by the CDC's Advisory Committee on Immunization Practices (ACIP).


NCPA Announcement: https://ncpa.org/newsroom/qam/2021/09/24/here-are-billing-codes-you-need-boosters


NCPA COVID-19 Vaccine Billing Handout: https://ncpa.org/sites/default/files/2021-01/COVID-19_vaccine_billing_for_NCPA_Members.pdf


NCPDP Emergency Preparedness Guidance: https://ncpdp.org/NCPDP/media/pdf/NCPDPEmergencyPreparednessGuidance.pdf


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