Eligibility of COVID-19 Booster Doses Expanded to All Adults

November 23, 2021

Effective for dates of service on or after November 19, 2021, the U.S. Food and Drug Administration (FDA) amended the Emergency Use Authorization (EUA) for the Pfizer-BiotNTech coronavirus disease 2019 (COVID-19) vaccine and the Moderna COVID-19 vaccine to allow for the administration of a booster dose to individuals 18 years of age and older who receive their second dose of a primary vaccination series at least six months ago.

As of the publication of this article, Medi-Cal can now accept most Medical, Outpatient and Pharmacy claims for the administration of said booster dose to the eligible population.

For the most current direction regarding billing guidelines for this expanded population, refer to the Pfizer-BioNTech COVID-19 Vaccine and Moderna COVID-19 Vaccine pages of the Medi-Cal Providers website.

Providers with questions should contact the Telephone Service Center (TSC) Help Desk at 1-800-541-5555, 8 a.m. to 5 p.m., Monday through Friday, except holidays. Border providers and out-of-state billers billing for in-state providers should call 1-916-636-1200.