With the Vaccines for Children program, Medicaid states since the vaccine is no charge to the practice, they will reimburse up to $17.85 for the administration, storage and such. Since there are numerous Medicaid HMO's that pay differently we bill both the Administration code (90471,90472, 90465,90466,90467,90468) and the vaccine code at $18.00 each. We know we will only get paid for one of the two.....
Straight Medicaid will usually pay the vaccine and zero to the admin. Half of the HMOs will pay only the admin and zero for the vaccine.
Either way we only get up to $17.85 per vaccine given.
Of course, don't forget the SL modifier on each vaccine code!
Hope that helps you.
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