21-105 COVID-19 Vaccines: What You Need to Know

Date: 01/29/21

Key details and information to help you and your staff understand the vaccine strategy

We are actively monitoring the rapidly evolving developments with the COVID-19 vaccines and their distribution. We will share necessary updates with you as soon as they are available.

Please continue to refer to the California Health & Wellness Health Alerts page for additional information and guidance regarding the COVID-19 vaccines.

How do I enroll to administer vaccines?

California COVID-19 Vaccination Program Enrollment information detailed in the steps below can be found at the California Department of Public Health website. 

Step 1: Get your IIS ID

Enroll in your local immunization registry to receive your Immunization Information System (IIS) ID for enrollment in CalVax. County-specific information is below.

County	Website
Alpine, Amador, Calaveras, Mariposa, Tuolumne	Healthy Futures
Other counties	California Immunization Registry

Step 2: Enroll in CalVax

• Use the Provider Enrollment Worksheet (pdf) to gather the information needed ahead of time to complete the online enrollment form on CalVax.
• Review CalVax Provider Enrollment: Before You Enroll (pdf), which details the steps and actions for providers to receive and administer the COVID-19 vaccines.
• Refer to the Readiness Checklist: Quick Start Guide (pdf), which outlines key tasks and resources to onboard to the vaccination program.

Vaccinate 58

The State of California is prioritizing vaccines for equitable distribution to everyone in California who wants it. The State expects to have enough supplies to vaccinate most Californians in all 58 counties by summer 2021.

Once a week, the federal government announces anticipated allocation figures for each state. The number of allocated doses provided by the federal government is a projection and subject to change.

Below are the steps for placing orders.

1. Local California providers are required to place their orders.
2. Orders are reviewed by the State and submitted to the federal government.
3. The federal government authorizes the order and submits the request to the manufacturer.
4. The manufacturer or central distributor ships the vaccine directly to the local California provider.
5. It can take a week or longer between when doses are allocated by the federal government to when they arrive at public health or provider offices and are ready for administration.

For more information, refer to Vaccines Official California State Government Website.

What is the vaccine distribution schedule?

Vaccinations in California are currently prioritized as follows:

Phase 1A	Phase 1B – Tier 1
Health Care Workers Long-term care residents Refer to CDHP Allocation guidelines for Phase 1A.	Individuals 65 and older Those at risk of exposure at work in the following sectors: Education and childcare Emergency services Food and agriculture

Simplifying Eligibility: In simplifying eligibility beginning mid-February, the state will implement a statewide standard under which health care workers, individuals 65+ and education and child care, emergency services and food and agriculture workers will be eligible to start making appointments to receive the vaccine, pending vaccine availability. These are the groups identified in Phase 1B, Tier 1. Future groups will become eligible based on age.

For more information on simplifying eligibility, refer to the press release from the California Government Operations Agency. 

Moving through vaccine phases

Health departments and providers may offer doses promptly to people in lower priority groups when:

• Demand subsides in the current groups, or
• Doses are about to expire according to labeling instructions, or
• Doses have been thawed and would otherwise go to waste.

To achieve the timely and maximum vaccination of Californians, the California Department of Public Health (CDPH) recommends the use of 50 percent of doses (Pfizer/BioNTech or Moderna vaccines) providers have received, as second doses to vaccinate individuals described above. For additional information, refer to Vaccines Official California State Government Website.

Pediatric distribution

The COVID-19 vaccines are not approved for pediatric use. The Pfizer/BioNTech COVID-19 vaccine is available to people ages 16 and older, and the Moderna COVID-19 vaccine is available to people ages 18 and older. Studies are in process to review how the vaccines affect children.

Where can people get information about vaccine availability – My turn?

If you are not providing the COVID-19 vaccine to your patients, refer patients to their county public health department.

A listing of local health departments by county is available through CDPH. It’s anticipated the Find out if it’s your turn on the California Department of Public Health website will be available to all counties in the near future.

Patients may also call 211 or 311 for information about the COVID-19 vaccines. These are non-emergency numbers that are State- and city-supported and can help direct callers to COVID-19 vaccine services in their area.

How do I record vaccine administration information for my patients?

Providers must record details of the vaccination into their system of record within 24 hours of administration and into their local immunization registry within 72 hours. For reporting information and details, refer to Reporting Doses Administered (pdf) from California Department of Public Health.

How is the cost of the vaccine covered?

COVID-19 vaccines are covered at no cost to members. The federal government is covering the cost of the vaccine; however, vaccine providers can charge an administration fee for giving someone the shot. Billing for the administration of the COVID-19 vaccine varies by line of business. Refer to the table below for coverage details and claim submission.

Product	Paid for by:	Submit claims to:
Medi-Cal	Federal government pays for the vaccine. Department of Health Care Services (DHCS) pays for the vaccine administration fee	DHCS

Additional information:

• No copay or cost share to members in or out of network.
• Prior authorization not required.
• Coverage for all COVID-19 vaccine types.

What CPT codes do I use to bill for the vaccine and/or administration?

The American Medical Association (AMA) has published updates to the CPT^® code set that includes new vaccine-specific codes to report immunizations for the novel coronavirus (SARS-CoV-2). The code set is updated as additional vaccines receive emergency use authorization (EUA) approval by the U.S. Food & Drug Administration (FDA).

Product/ drug code	Authorized age groups	Administration	Admin codes	NDC10/NDC11 labeler product ID (Vial)
93100 Pfizer-BioNTech	> or equal to 16 years	(30 μg, 0.3 ml each): three weeks (21 days) apart	0001A (1st dose) 0002A (2nd dose)	59267-1000-1 59267-1000-01
91301 Moderna	> or equal to 18 years	(100 μg, 0.5 ml: one month (28 days) apart	0011A (1st dose) 0012A (2nd dose)	8077-273-10 9077-0273-10

What are adverse events and how are they reported?

Mild or severe adverse events can result from the COVID-19 vaccines. Recommendations, as well as clinical considerations for managing adverse events can be found on the Centers for Disease Control and Prevention (CDC) website.

Provider-reported vaccine side effects

You can report an adverse event from the COVID-19 vaccines on behalf of your patient using the Vaccine Adverse Event Reporting System (VAERS).

Patient-reported vaccine side effects

Patients can report any side effects from the vaccines directly to the CDC using V-safe^SM smartphone-based tool. Patients may be contacted by someone from the CDC to check on them and get more information, depending on the answers provided. V-safe will also remind patients to get their second COVID-19 vaccine dose if needed. Patients can register for V-safe.

Where can patients get reminders for the second dose of the vaccine?

Patients can register for free at VaxTextCOVID-19 Vaccine Second-Dose Reminder website.

They can also text ENROLL to 1-833-VaxText (829-8398).

Register for a COVID-19 vaccine webinar to learn more

To learn more about the following topics, use the webinar registration:

• COVID-19 vaccines
  • Provider selection
  • State and federal programs
• Vaccine best practices
  • Administration
  • Documentation
  • Adverse event notification
• Vaccine hesitancy
  • Communication strategy
  • Key points on communicating about the COVID-19 vaccine
• Health plan updates
  • HEDIS^® medical record collection
  • State minimum performance measures released
  • Supplemental data: Claims and encounters

Date	Time (Pacific time)	Date	Time (Pacific time)
February 4, 2021	Noon–1:30 p.m.	March 23, 2021	Noon–1:30 p.m.
February 23, 2021	Noon–1:30 p.m.	April 14, 2021	2–3:30 p.m.
March 11, 2021	2–3:30 p.m.	April 27, 2021	Noon–1:30 p.m.

COVID-19 vaccines resources available for providers

For more information on the COVID-19 vaccines, refer to the following resources:

Resource	Description
Health Net COVID-19 Updates & Alerts for Providers	Health plan information and guide on the COVID-19 vaccines and pandemic.
DHCS COVID-19 Vaccines Administration FAQs (pdf)	Providers FAQs on COVID-19 Vaccines administration.
CMS toolkit	Provides information on vaccines policies and guidance.
DHCS COVID-19 Response	Contains detailed information about our actions during the COVID-19 emergency.
Health care professionals: Preparing for COVID-19 vaccination	How to talk to patients about the vaccines.
What Clinicians Need to Know About the Pfizer-BioNTech COVID-19 Vaccine (pdf)	Presentation about the Pfizer-BioNTech vaccine.
COVID-19 vaccination training for health workers	World Health Organization training providing general information on COVID-19 and specific information on storage, handling and administration of the vaccine.
Vaccine Index	Immunization action coalition providing practical tools for providers to understand COVID 19 vaccine and preparing clinic for vaccination.