[Ohioaap-practicemanagers] Caresource Vaccine Admin

[Melanie Farkas]

Sharing from a practice manager:

We have recently seen denials of 90471 from CareSource. When I called them, I was told by CareSource and Medicaid, that 90471 is only paying for ages 18 years and older. This was supposed to have taken effect the first of the year, however we have had a lot of paid 90471 from CareSource for the past 3 months. I was told to use 90460 instead of 90471. CareSource will not pay for the additional components, 90461.

In talking to Medicaid, they quit paying for the vaccine as of the first of the year, and will only pay the 90460 for vaccine administration. However, they have yet to pay on the 90460. At this point in time, we are getting no reimbursement from Medicaid for the vaccine or the administration.

Deb Howell
Powell Pediatric Care


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