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Possible online services disruption due to Internet related outage

A worldwide technology outage is causing disruption to some State of Illinois online systems.  We are aware of this issue and are diligently working on restoration.

Elizabeth M. Whitehorn, Director

Provider Notice issued 09/28/2023

 

Date: September 28, 2023
​To: Enrolled Pharmacies 
​Re: COVID-19 Vaccine Billing Instructions

The Department of Healthcare and Family Services (HFS) is notifying all pharmacies of billing instructions for the new commercial COVID-19 vaccines now in circulation. These instructions apply to the fee-for-service program only.

As HFS is still finalizing programming for the administration fee for the COVID vaccine, pharmacies cannot use “MA” in the Professional Service Code Field, nor add the administration fee until the new programming is complete. Pharmacies can still provide COVID-19 vaccinations and submit claims to HFS for reimbursement for the cost of the vaccination plus a dispensing fee as they would for other vaccinations that do not pay an administration fee. 

Once the programming is complete, pharmacies can then void and rebill for services rendered to receive the full payment including the applicable administration fee.

A provider notice will be sent to pharmacies once programming is complete and pharmacies can bill for the administration fee. The void and rebill process to receive full payment for claims that were submitted without receiving the administration fee can commence at that time.   

Questions regarding this notice may be directed to a pharmacy consultant in the Bureau of Professional and Ancillary Services at 877-782-5565.

 

Kelly Cunningham, Administrator
Division of Medical Programs