Medicaid Billing for Covid-19 Vaccination Counseling

Effective for dates of service beginning December 1, 2021, FQHCs may bill PPS for Covid-19 vaccination counseling for patients who have not yet received their first dose. Health centers are encouraged to include other E/M or clinical services in connection with the counseling session. Counseling sessions delivered via audio-only telehealth should use the off-site rate code 4012 consistent with other audio-only visits. The Department has issued additional guidance on coverage for vaccine counseling, including a limit of four counseling sessions per vaccine dose, up to twelve visits per year. Additional information must be documented including confirmed vaccination status and reason for patient vaccine hesitancy. For complete guidance, click here.

Published on 02/16/2022