Wiki Billing for VFC vaccines

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Since the patient is elig for Medicaid then they fall under the VFC and we give them state supplied imms. Hope this helps! :)
 
In Texas, several years ago at a VFC training, we were told to not use VFC vaccines if patient had a primary insurance UNLESS the vaccinations would be applied to the patient deductible AND this would create a hardship for patient/family. Ex: patient had $500.00 deductible not yet met, and vaccinations would go against this $500.00, and funds were limited, then we could use VFC vaccines with documentation to support VFC use. Using VFC vaccines was part of the "herd immunity" for the greater good of all.
 
In our office (NY) if they have a primary insurance that is not state funded and immun. are covered by that plan then we bill immun. as they are. If not covered by primary plan we then change to VFC for that plan as well.

S. Berry CPC, CPMA
 
In sc any patient with an eligible medicaid plan as a secondary is eligible to receive VfC vaccine our state medicaid site gives specifics on how to do this since if billing vfc our state only allows One unit of 90460 and a Max of two units of 90461
 
Hi. I am in SC too and was wondering how you bill the immunization only visit for Medicaid patients? Auditors recently told us we could not use 90460 unless the provider counseled the patient. However, for flu vaccines, 2nd Gardasil, etc....the Medicaid patients just see the nurse. We have tried 90471, but they're getting rejected. Anyone who knows the answer for South Carolina Medicaid, would appreciate the help. I have tried to call Medicaid, but they refer me back to the provider handbook which does not address immunization only visits.
 
can't track it down right now, but the bulletin should be in the sc dhhs archives. It specifically instructs offices giving vfc vaccine to use code 90460 max 1 unit/day/vaccine not component and 90461 max 2units/day/vaccine not component.not to exceed max reimbursement of 3 Whether or not counseling is provided.relates to the add'l payment in regards to ACA. I would print it and keep it for any audit by that payer. Select Health and Blue choice Medicaid also issued a similar bulletin
 
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