On September 1, 2022, the Centers for Disease Control and Prevention (CDC) announced recommendations for a booster dose of updated COVID-19 vaccines: Moderna COVID-19 vaccine, bivalent for individuals 18 years of age and older and Pfizer/BioNTec COVID-19 vaccine, bivalent for individuals 12 years of age and older.
The updated vaccines protect against both the original SARS-CoV-2 strain and the most recent Omicron subvariants. People are eligible to receive an updated booster two months after their last vaccination, whether it was a primary or booster dose.
The U.S. Department of Health and Human Services has purchased 175 million doses of the updated vaccines and is distributing these at no charge to providers for immediate vaccination to your eligible members. The standard administration fee of $40 per vaccination will be submitted by providers under your health plan’s pharmacy benefit. Your members will have a $0 cost share.
Newly Approved Vaccine Products as of 09/02/2022
|
Vaccine |
NDC |
Product Name |
Manufacturer's (Labeler) Name |
Generic Name |
Utilization Management Criteria |
|
PFIZER BIVAL INJ BA4/BA5 |
59267030401 59267030402 59267140401 59267140402 |
PFIZER-BIONTECH COVID-19 VACCINE/BIVALENT/BA.4/BA.5 |
PFIZER-BIONTECH |
COVID-19 MRNA BIVALENT VACCINE-PFIZER IM SUSP 30 MCG/0.3ML |
Min Age = 12 Years Max 1 dose/365 days |
|
MODERNA BIVA INJ BA4/BA5 |
80777028205 80777028299 |
MODERNA COVID-19 VACCINE/BIVALENT/BA.4/BA.5 |
MODERNA US INC |
COVID-19 MRNA BIVALENT VACCINE-MODERNA IM SUSP 50 MCG/0.5ML |
Min Age = 18 Years Age edits may be overridden if DOB is incorrect Max 1 dose/365 days |
Please contact your pharmacy benefit manager (PBM) or your MedCost Account Manager if you have any questions.