[Ohioaap-practicemanagers] Does this guidance on billing VFC vaccine help?

[Combs, Frank]

Jon, I have requested some feedback to your questions and will get back with you as soon as I receive anything back.  Talk to you soon, Frank

From: Price, Jonathan
Sent: Wednesday, April 27, 2016 2:08 PM
To: ohioaap-practicemanagers at lists.deltaforce.net
Cc: Pastva, Robert; Combs, Frank; mfarkas at ohioaap.org
Subject: Does this guidance on billing VFC vaccine help?

Hi all,
    A pediatrician's office in the Columbus area got this guidance from ODH on how to bill the various Medicaid Managed Care Plans (MCPs) for vaccines and vaccine admin, a hot subject as you know. Please look at it and tell me 1) whether this method has worked for you or not, and 2) what would you add to it in terms of using modifiers or any other detail that has made it work for you:
A)     ODM and MCPs excluding CareSource- Vaccine CPT with zero dollar amount (or .01 if needed) and admin fee attached to the admin CPT (90460 only)
B)      CareSource- Vaccine CPT with zero dollar amount (or .01 if needed) and admin fee attached to the admin CPT (90471 for the initial and 90472 for subsequent).


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