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Elizabeth M. Whitehorn, Director

Provider Notice Issued 04/24/2024

Date:   April 24, 2024

To:      Enrolled Physicians, Physician Assistants (PAs), Advanced Practice Registered Nurses (APRNs), Local Health Departments (LHDs), Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), Encounter Rate Clinics (ERCs), Home Health Agencies, and School Based/Linked Health Centers (SBLHCs)

Re:      Update to Rate Changes for Administration of COVID-19 Vaccine – Effective for Dates of Service Beginning January 1, 2024   _______________________________________________________________________________________________________________________________________________________

This notice provides an update on the Department of Healthcare and Family Services’ (HFS) plan to change the methodology by which HFS will reimburse providers for costs associated with COVID-19 vaccine administration.

By provider notice dated January 31, 2024, HFS informed providers that the agency had submitted a State Plan Amendment (SPA) to the federal Centers for Medicare & Medicaid Services (CMS) to better align reimbursement to providers for COVID-19 vaccine administration with HFS’ reimbursement methodologies for other vaccines. That notice identified the proposed rates.

The SPA regarding the rate changes has been approved and is effective for dates of service beginning January 1, 2024. Fee-for-service (FFS) practitioner claims with dates of service on and after January 1, 2024, that had been held by HFS have been released for processing to be reimbursed at the revised rates.

Questions regarding this notice may be directed to the Bureau of Professional and Ancillary Services at 877-782-5565 or the applicable managed care plan.

 

 

Kelly Cunningham, Administrator
Division of Medical Programs