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Wiki FLORIDA MEDICAID VACCINE CODING

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OnelM2023

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46
Location
Cape Coral, FL
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hello everyone. A little help here if possible. I truly dont understand what I am doing wrong that I dont get paid for the extra components of the vaccines....See below

1708968780478.png
1708968806217.png
 
Appreciate your response, But I thought Florida Medicaid paid for the additional components. Is anyone from Florida that can help me with this..
 
Sorry, I am not on the forums consistently.

Florida Medicaid will not pay for additional components.

"As part of the Patient Protection and Affordable Care Act (PPACA) regulations the Centers for Medicare & Medicaid Services (CMS) require Medicaid programs to reimburse for VFC services on administration codes 90460, 90471, 90472, 90473, and/or 90474 rather than the serum/toxoid code. Per the PPACA legislation, CPT code 90461 is NOT reimbursable."
 
Hello,

Thank you for the response, but I have also billed under 90471 and 90472 for the additional components. So, they just pay for a limit of 4 in total for a claim? for example:

90700, 90648, 90671

So what you are saying it should be billed like this:

90460X3
90700
90460x1
90648
90460x1
90671

or

90460x1
90700
90460x1
90648
90460x1
90671
90472x1
90472x1
 
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