Wiki Correct Way to Code for VFC Medicaid program for Pediatrics

[tilquist3@comcast.net]

What is the correct way to bill for a pediatrics practice for VFC program?

 

[jardisi@outlook.com]

In CT the vaccines were billed with their respective CPT codes and 0.00 as the charge. For administration Medicaid only pays on the 90460 for the first component of administration with counselling - 90461 is not paid as per contract. Some insurances required the SL modifier for state funded vaccines. Documentation had to include all the normal components - NDC, Lot, Expiration, dose, admin site, etc. Other required documentation was if the vaccine was VFC/Non-VFC funded, then documented what type of insurance the patient had. They had a lot of guidelines. I am not sure if the rules are the same in other states. I hope some of this helps.