Following the U.S. Food and Drug Administration’s (FDA) amendment to the Emergency Use Authorization (EUA) on March 14, 2023, healthcare providers gained the ability to administer a Pfizer-BioNTech COVID-19 bivalent booster dose to certain pediatric patients. In response, the American Medical Association (AMA) released a new CPT® code on March 17, 2023, to accurately report administration of this booster vaccine.
New Administration Code: 0174A
The newly established CPT® code 0174A is designated for the administration of the Pfizer-BioNTech COVID-19 bivalent booster vaccine delivered via intramuscular injection. This code specifically applies to the preservative-free, tris-sucrose formulation containing a 3 mcg/0.2 mL dosage.
When reporting 0174A, providers must also bill the corresponding vaccine product code 91317, which identifies the Pfizer-BioNTech bivalent COVID-19 vaccine itself. Both codes describe a vaccine formulated to provide protection against multiple strains of the virus and share the same dosage specification.
Patient Eligibility Requirements
Under the revised EUA, a single booster dose may be administered to children 6 months through 4 years of age who completed a primary vaccination series consisting of three doses of the monovalent Pfizer-BioNTech COVID-19 vaccine. The booster must be given at least two months after completion of the primary series.
For coding purposes, completion of the monovalent primary series is represented by vaccine product code 91308. The administration codes associated with that three-dose series are:
- 0081A – First dose administration
- 0082A – Second dose administration
- 0083A – Third dose administration
Understanding the Relationship Between 0173A and 0174A
To accommodate the introduction of the new booster administration code 0174A, the AMA made a minor revision to CPT® code 0173A. Specifically, the punctuation within the code descriptor was changed from a comma to a semicolon before the phrase “third dose.” This formatting adjustment groups 0173A and 0174A into the same code family, allowing them to share a common descriptor while distinguishing between administration of a third primary-series dose and a booster dose.
Both codes relate to administration of Pfizer’s bivalent COVID-19 vaccine containing a 3 mcg/0.2 mL dosage, but they serve different purposes.
Important Booster Limitation
Providers should note that 0174A applies only to children who completed a three-dose monovalent Pfizer-BioNTech primary series. Beginning in December 2022, children aged 6 months through 4 years who received the first two doses of the monovalent vaccine were directed to complete their primary series with a bivalent third dose, reported using 0173A. According to the EUA, these patients are not eligible to receive the booster dose reported with 0174A.
Accurate identification of the patient’s vaccination history is therefore essential to ensure proper CPT® code selection and compliance with EUA guidelines.