© Copyright 2025 American Medical Association. All rights reserved.
The CPT® Code 91305 refers to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine, specifically designed to combat coronavirus disease (COVID-19). This vaccine utilizes a messenger RNA (mRNA) technology encapsulated in lipid nanoparticles (LNP), which is a method that allows the mRNA to be delivered effectively into human cells. The vaccine contains a dosage of 30 mcg in a 0.3 mL volume and is formulated without preservatives, ensuring a purer product for intramuscular administration. The mRNA included in the vaccine encodes the spike protein of the SARS-CoV-2 virus, which is critical for the virus's ability to infect human cells. Upon administration, the body's cells utilize this mRNA as a template to produce the spike protein, which is then recognized by the immune system as a foreign entity. This recognition triggers an immune response, leading to the production of antibodies that can neutralize the virus if the individual is exposed in the future. The vaccine's formulation includes tris-sucrose, which acts as a stabilizing agent, allowing the vaccine to be stored at standard refrigerator temperatures, thus facilitating easier distribution and storage. It is important to note that while this code reports the supply of the vaccine, the actual administration of the vaccine is billed separately using the appropriate administration code, depending on the specific dose given. This vaccine is part of a two-dose series, with a third booster dose available for populations recommended by the Centers for Disease Control and Prevention (CDC).
© Copyright 2025 Coding Ahead. All rights reserved.
The COVID-19 vaccine, represented by CPT® Code 91305, is indicated for the prevention of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, which can lead to coronavirus disease (COVID-19). The vaccine is specifically designed for individuals who are part of the CDC-recommended populations, including those who may be at higher risk for severe illness from COVID-19.
The administration of the COVID-19 vaccine involves several key procedural steps to ensure safety and efficacy. First, the healthcare provider must verify the patient's eligibility for vaccination, including checking for any contraindications or previous allergic reactions to vaccine components. Once eligibility is confirmed, the provider prepares the vaccine by gently swirling the vial to ensure proper mixing of the mRNA-LNP formulation. The vaccine is then drawn into a sterile syringe, ensuring that no air bubbles are present, which could affect the dosage.
Following the administration of the COVID-19 vaccine, patients are typically advised to remain at the healthcare facility for a brief observation period, usually around 15 to 30 minutes, to monitor for any immediate allergic reactions. Patients may experience common side effects such as soreness at the injection site, fatigue, headache, or mild fever, which are generally self-limiting. It is important for patients to be informed about the potential need for a second dose, as well as a booster dose, depending on CDC recommendations. Additionally, patients should be educated on the importance of continuing to follow public health guidelines, including mask-wearing and social distancing, even after vaccination, until community immunity is achieved.
| Short Descr | SARSCOV2 VAC 30 MCG TRS-SUCR |
| Medium Descr | SARSCOV2 VACCINE 30MCG/0.3ML TRIS-SUCROSE IM USE |
| Long Descr | Severe acute respiratory syndrome coronavirus 2 (SARS-CoV- 2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular use |
| Status Code | Not Valid for Medicare Purposes |
| Global Days | XXX - Global Concept Does Not Apply |
| PC/TC Indicator (26, TC) | 9 - Not Applicable |
| Multiple Procedures (51) | 9 - Concept does not apply. |
| Bilateral Surgery (50) | 9 - Concept does not apply. |
| Physician Supervisions | 09 - Concept does not apply. |
| Assistant Surgeon (80, 82) | 9 - Concept does not apply. |
| Co-Surgeons (62) | 9 - Concept does not apply. |
| Team Surgery (66) | 9 - Concept does not apply. |
| Diagnostic Imaging Family | 99 - Concept Does Not Apply |
| APC Status Indicator | Non-Covered Service, not paid under OPPS |
| Berenson-Eggers TOS (BETOS) | none |
| MUE | Not applicable/unspecified. |
| 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. |
| GC | This service has been performed in part by a resident under the direction of a teaching physician |
| SL | State supplied vaccine |
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Date
|
Action
|
Notes
|
|---|---|---|
| 2025-01-01 | Deleted | First appearance of code deletion in codebook. |
| 2024-01-01 | Note | First appearance of Aug 2022 AMA guideline updates in codebook. |
| 2023-11-01 | Deleted | Code deleted. See 91318, 91319, 91320, 91321, 91322. |
| 2023-04-18 | Note | Changes made to dosing information. |
| 2023-04-18 | Note | These codes (included in the guidelines) are no longer authorized for use in the United States: 0001A, 0002A, 0003A, 0004A, 0071A, 0072A, 0073A, 0074A, 0081A, 0082A, 0083A. |
| 2023-04-18 | Note | AMA guideline changed to include 0121A, 0151A, 0171A, & 0172A. Published to website 2023-05-01. Received FDA approval effective retroactively to 2023-04-18. |
| 2023-04-18 | Note | No longer authorized for use in the United States. |
| 2023-03-14 | Note | AMA guideline changed to include 0174A. Published to website 2023-03-17. Received FDA approval effective retroactively to 2023-03-14. |
| 2023-01-01 | Added | First appearance in codebook. |
| 2022-12-08 | Note | AMA guideline added and includes 0173A. Published on AMA website December 9, effective 2022-12-08. |
| 2022-10-12 | Note | AMA Guideline changed. 0154A received FDA approval. |
| 2022-08-31 | Note | AMA guideline changed to include 0124A and 0154A effective upon receiving emergency Use Authorization or approval from the FDA |
| 2022-08-31 | Note | AMA Guideline changed. 0124A received FDA approval effective immediately. |
| 2022-08-31 | Note | Changes made to vaccine name, product & dosing information, & patient age (12+). |
| 2022-06-17 | Note | AMA Guideline changed. 0081A, 0082A, 0083A received approval. |
| 2022-06-07 | Note | AMA guideline changed to include 0083A effective upon receiving emergency Use Authorization or approval from the FDA. |
| 2022-05-17 | Note | AMA Guideline changed. 0074A received approval. |
| 2022-04-26 | Note | AMA guideline changed to include 0074A effective upon receiving emergency Use Authorization or approval from the FDA. |
| 2022-02-01 | Note | AMA guideline changed to include 0081A, 0082A effective upon receiving emergency Use Authorization or approval from the FDA. |
| 2022-01-03 | Note | AMA guideline changed to include 0073A. FDA approval received 2022-01-12. Effective retroactively to 2022-01-03. |
| 2021-10-29 | Note | FDA approval granted for codes 0051A, 0052A, 0053A, 0054A, 0071A, 0072A. |
| 2021-10-29 | Added | FDA Approval Received |
| 2021-10-06 | Note | AMA guideline changed to include 0071A and 0072A (effective upon receiving Emergency Use Authorization or approval from the FDA.) |
| 2021-09-22 | Note | 0004A received FDA approval. |
| 2021-09-03 | Note | AMA guideline includes 0001A, 0002A, 0003A: Published on AMA website & received FDA approval prior to the addition of 91305. |
| 2021-09-03 | Note | AMA guideline added. Includes 0004A, 0051A, 0052A, 0053A, 0054A effective upon receiving emergency Use Authorization or approval from the FDA. |
| 2021-09-03 | Added | Published on AMA website. Effective upon receiving Emergency Use Authorization or approval from the Food and Drug Administration. |
|
Code
|
Description
|
|---|---|
| Z23 | Encounter for immunization |
| No matching codes found | |
|
Code
|
Description
|
|---|---|
| M0201 | Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patient's home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patient's home |
| No matching codes found | |