Effective September 1, 2025, NYRx, the state's Medicaid Pharmacy program, announced coverage for the 2025-2026 formulations of the COVID-19 vaccine. Effective September 5, 2025, in accordance with the Executive Order #52 and the guidance issued by the Commissioner of Health, pharmacists are authorized to order patient-specific orders for COVID-19 vaccination for patients aged 3 years and older for off-label usage of COVID-19 vaccine. See Advisory Immunization Notification titled 2025-20206 COVID-19 Guidance for Pharmacists located at https://commerce.health.ny.gov. Enrolled pharmacy providers will be reimbursed for vaccine cost and administration when administered to eligible members. Pharmacies will bill NYRx using the National Council on Prescription Drug Programs (NCPDP) D.0 format.
The Department has since then issued an update on non-patient specific standing order for the administration of the Pfizer-BioNTech updated COVID-19 vaccine (2024-2025 Formula) for persons 5 years of age and older by pharmacists.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.