Reply To: Adult Medicaid billing for flu

[Missouri Public Health Association]

Straight Medicaid or the managed care companies will reimburse 90471 for the admin fee of an adult flu shot. The actual vaccine for adult flu will always be billed pharmacy to straight Medicaid, even if the patient has a managed care company. You will need to include both lines – 90471 and vaccine 90686 on the admin fee billing in order to get paid. We have no problem getting reimbursed as long as the patient doesn’t have limited benefits. Feel free to contact me if you have other questions. Brenda.phillips@capecountyhealth.com