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Has anyone been successful in billing the pediatric vaccine counseling codes to people refusing vaccinations?
If a child gets their routine vaccinations but the parent refuses the COVID 19 vaccine can we still bill the G0314 for counseling on the COVID 19 vaccine?
Effective for dates of service on or after December 2, 2021, providers may bill for stand-alone
vaccine counseling visits in which providers talk to families about the importance of vaccines
for children under age 21 as part of the Early and Periodic Screening, Diagnostic and
Treatment (EPSDT) benefit, even when the child does not receive a vaccine.
Parents or guardians of MO HealthNet children can be counseled, without the children
present, on the benefit of receiving the vaccine even if the parent or guardian is not enrolled
in MO HealthNet. The vaccine counseling session for the parent or guardian can be billed
using the child’s MO HealthNet ID.
There is no requirement for a specific diagnosis code.
All enrolled providers approved to administer pediatric vaccines can provide this service.
Vaccine counseling can be provided in person or via telehealth. Please see Section 13.69.C
of the Physician’s Manual found on the MO HealthNet website at:
http://manuals.momed.com/collections/collection_phy/print.pdf for instructions on billing for
telehealth services.G0312 : Immunization counseling by a
physician or other qualified
health care professional when
the vaccine(s) is not admin administered on the same date
of service for ages under 21, 5
to 15 mins time. $25.38G0313 Immunization counseling by a
physician or other qualified
health care professional when
the vaccine(s) is not
administered on the same date
of service for ages under 21,
16-30 mins time. $50.75G0314 Immunization counseling by a
physician or other qualified
health care professional for
COVID-19, ages under 21, 16-
30 mins time. $50.75G0315 Immunization counseling by a
physician or other qualified
health care professional for
COVID-19, ages under 21, 5-
15 mins time. $25.38That is why it is so important to sign up and check for new Medicaid provider bulletins. Michelle this is great news. We talk ourselves blue in the face some days. We really try to get these kids parents to do HPV and Men B. Seems that the moms are more open to them than the dads.
Cheryl don’t get excited too quick 🙂 I’m curious to know if some of the managed care plans will actually pay….or we will spend a decade jumping through hoops. This has evidently been active since December and they JUST posted it in the provider bulletin 🤷🏻♀️
ICD-10 code Z71.85 for Encounter for immunization safety counseling is a medical classification as listed by WHO
I am using this diagnosis code so now we will see what happens!https://dss.mo.gov/mhd/providers/pages/bulletins.htm is the page where bulletins are posted.
Many of the pages on dss.mo.gov have a place to sign up for email updates. The problem is most are not for public health so I selected physicians and clinics
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