On March 14, 2023, the U.S Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC) expanded the use of the Pfizer-BioNTech coronavirus 2019 (COVID-19) bivalent vaccine for use as a booster dose in children six months through four years of age, to be administered after completing the three-dose primary series with the monovalent Pfizer-BioNTech COVID-19 vaccine. However, the California Department of Health Care Services (DHCS) recently informed providers that its system is not yet able to appropriately adjudicate claims for the bivalent booster dose for small children.

DHCS is urging Medi-Cal providers to hold such claims until the claims adjudication system is prepared to appropriately adjudicate submitted claims. Claims submitted before that time will be rejected.

For more information, see the DHCS COVID-19 Medi-Cal Response page.