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  • Medicaid Provider Alert: Provider revalidation has begun and those not completing the process risk disenrollment.  Check your account now to learn when your revalidation is due. More information here.
Elizabeth M. Whitehorn, Director

Provider Notice Issued 10/31/2022

Date:    October 31, 2022    

To:       Enrolled Physicians, Advanced Practice Registered Nurses, Physician Assistants, Local Health Departments, Encounter Rate Clinics, Federally Qualified Health Centers, Rural Health Clinics, Hospitals, and Pharmacies        

Re:      COVID-19 Bivalent Booster Vaccination Age Range Lowered

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This notice provides an updatein coverage of the new COVID-19 bivalent boosters. The update applies to claimsfor customers covered under traditional Medicaid fee-for-service (FFS) andthe HealthChoice Illinois (HCI)managed care organization (MCO) plans.

 

By practitioner providernotice dated September 30, 2022, and pharmacy providernotice dated October 5, 2022, the minimum age for the Pfizer-BioNTech bivalentbooster was identified as 12 years. The Moderna bivalent booster minimum agewas 18 years.

 

Effective October 12,2022, the U.S. Food and Drug Administration (FDA), in association with theCenter of Disease Control (CDC), authorized the administration of the Pfizer-BioNTechbivalent booster beginning at 5 years of age and the Moderna bivalentbooster beginning at 6 years of age. All other information in the above-referencedprovider notices remains the same.

 

The HFS COVID-19 Fee Schedule has beenupdated. Questions regarding vaccine administration may be directed to theBureau of Professional and Ancillary Services at 877-782-5565 for the FFSprogram, or the applicable HCI MCO plan.

 

 

 

Kelly Cunningham,Administrator

Division of Medical Programs