The COVID-19 pandemic forced healthcare systems to adapt quickly. Beyond treatment, one major challenge was billing — how to accurately code for new tests, therapies, and vaccines so insurers, hospitals, and researchers could stay on the same page.
That’s where CPT for COVID-19 comes in. CPT (Current Procedural Terminology) codes are the universal language of medical billing. For COVID-19, they cover everything from a nasal swab test to vaccine administration to plasma transfusions.
For patients, CPT is more than paperwork. It decides whether treatment is covered, how much it costs, and what options are available. For billers, accuracy with CPT codes means fewer denials and smoother claims.
What is CPT Treatment for COVID-19?
In addition to billing codes, “CPT” often refers to Convalescent Plasma Therapy (CPT). This treatment involves giving plasma from recovered COVID-19 patients to those who are sick, with the goal of transferring protective antibodies.
- How CPT works: Antibodies in donor plasma may neutralize SARS-CoV-2, reducing severity.
- When it’s considered: Hospitalized patients with moderate to severe infection, especially those with weakened immune systems.
- Benefits: Passive immunity, potential faster recovery.
- Risks: Allergic reactions, transfusion complications, or limited benefit in advanced disease.
CPT Codes for COVID-19: Complete List and Uses
Here’s a breakdown of all relevant CPT codes created or repurposed during the COVID-19 pandemic, with plain-English explanations.
1. COVID-19 Diagnostic Testing Codes
- 87635 – Detects SARS-CoV-2 via nucleic acid (PCR test, single target).
Used for the standard COVID-19 PCR swab test. - 87636 – Detects SARS-CoV-2 plus Influenza A/B (multiplex PCR).
Used when testing for COVID-19 and flu together. - 87637 – Detects SARS-CoV-2, Influenza A/B, and RSV.
Used for broader respiratory virus panels, including COVID-19. - 87426 – Antigen detection for SARS-CoV-2.
Covers rapid antigen testing. - 86328 – Antibody test for SARS-CoV-2, single-step method.
Covers fingerstick or point-of-care antibody tests. - 86769 – Antibody test for SARS-CoV-2, multiple-step method.
Covers lab-based antibody testing to check for past infection.
2. COVID-19 Vaccine Product & Administration Codes
Each COVID-19 vaccine has its own product code (913xx) plus matching administration codes.
- 91300 – Pfizer-BioNTech COVID-19 vaccine (initial doses).
- 91301 – Moderna COVID-19 vaccine (initial doses).
- 91303 – Johnson & Johnson (Janssen) COVID-19 vaccine.
- 91305 – Novavax COVID-19 vaccine.
- 91320–91322 – Updated bivalent formulations.
Administration codes (commonly used with the above):
- 90460 / 90461 – Vaccine administration, with counseling (under 18 years).
- 90471 / 90472 – Immunization administration, per dose (standard).
Used whenever a provider gives the vaccine and documents administration.
3. Convalescent Plasma Therapy (CPT) Codes
For plasma transfusion used as COVID-19 treatment:
- 36430 – Blood transfusion, plasma or whole blood.
Covers the actual transfusion procedure. - P9017 – Fresh frozen plasma, donor.
- P9019 – Plasma, fresh frozen, 1 unit.
- P9059 – Plasma, frozen within 24 hours of collection.
- P9060 – Plasma, frozen within 24 hours, each unit.
- P9100 – Pathogen-reduced plasma.
These describe the type of plasma used for therapy.
Quick Reference for Billers
- Testing: 87635, 87426, 86769
- Vaccines: 91300–91322, 90471–90472
- Therapy (Plasma): 36430, P9017–P9100
Cost and Billing Considerations
- CPT cost with insurance for coronavirus: Most payers covered COVID-19 testing and vaccination at no cost. Plasma therapy was more complex — coverage depended on medical necessity and trial status.
- Price of CPT treatment for COVID-19: Plasma transfusions could cost several hundred to thousands of dollars.
- Affordable CPT options for COVID-19: Nonprofit hospitals and government-funded programs often reduced or eliminated patient costs.
- Discount on CPT for coronavirus near me: Some centers offered assistance programs.
Effectiveness and Research
- Success rates: Results were mixed. Plasma helped some patients early in infection but wasn’t consistently effective.
- Latest research: By 2023, most guidelines recommended plasma only in special cases, like immunocompromised patients.
- CPT vs other treatments: Antivirals (Paxlovid, Remdesivir) and steroids showed stronger benefits overall.
Patient Access and Experiences
- Where to get CPT for coronavirus locally: Major hospitals, donation centers, and research sites.
- How to get CPT for coronavirus: Physician referral plus eligibility screening.
- Patient experiences with CPT for COVID-19: Some improved quickly, others saw no change — highlighting the importance of individualized care.
Key Takeaways
- CPT for COVID-19 covers billing codes and Convalescent Plasma Therapy.
- Codes exist for testing, vaccines, and treatment.
- Plasma therapy played a role early in the pandemic but is now used selectively.
- Accurate CPT coding is essential for billers and providers to avoid denials.