Medicaid Billing of Immunizations

[Missouri Public Health Association]

Hello Billers!

While we are on the subject of billing shots, I wanted to verify we have the correct billing cheat sheet for child immunizations. Can someone please reference where to look for up to date pricing for this service?

Thank you,
April Jacks

[Missouri Public Health Association]

This is CDC VFC price list.
https://www.cdc.gov/vaccines/programs/vfc/awardees/vaccine-management/price-list/index.html
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[Missouri Public Health Association]

Thank you Alisha.

This price list you provided is at a much higher rate than what we have been billing here. Are you actually billing and getting paid for Medicaid immunizations at these price rates? Example it says vaxelis is $95.07 but for us we have been getting $31.62.

Thank you for your help

[Missouri Public Health Association]

We will bill it but No they will not pay that rate. The only thing they say is $5.35 per component but with managed medicaid its all what the contract rate is. it would be really nice if we had an update manual with all codes and prices. Maybe someone else has more information that can help.

[Missouri Public Health Association]

I appreciate you explaining that to me.

Thank you again Alisha!!

[Author]

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