COVID-19 Update – Boosters and Billing Reminders

Tuesday, May 17, 2022

We are now officially in the third year of the COVID-19 pandemic and continue to learn and shift our day-to-day operations to meet continuously evolving health care needs. Please take a moment to review the latest COVID-19 vaccine coverage and billing guidelines.  

TRICARE covers the COVID-19 vaccine in accordance with Centers for Disease Control and Prevention (CDC) guidelines. Visit the CDC website for current details. The effective date of coverage for CDC-recommended vaccines is the date Advisory Committee on Immunization Practices (ACIP) vaccine recommendations are published in a Morbidity and Mortality Weekly Report (MMWR); or if the CDC has published an interim recommendation, the effective date of coverage is the date the interim recommendation is published on the CDC website.

Second booster doses 
The CDC now recommends a second booster of the Pfizer-BioNTech or Moderna vaccine for individuals aged 50 and older and for those age 12 and older who are immunocompromised. This booster should be given at least four months after the first booster. Vaccination continues to be vital for protecting people from infection and serious illness, and we hope you will encourage eligible patients to take this extra precaution. More information on boosters and the CDC’s latest recommendations is available at https://www.cdc.gov/coronavirus/2019-ncov/vaccines/booster-shot.html. 

Proof of prior vaccines
To help expedite claims processing, please include proof of prior vaccines, such as a copy of the patient’s vaccination card or electronic health record that specifies date(s) administered, when submitting claims to Health Net Federal Services, LLC. 

For up-to-date COVID-19 information, resources and links, visit our COVID-19 resource page.