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Provider Notice Issued 02/08/2021

Date:    February 8, 2021

 

To:       Enrolled Pharmacy Providers

 

Re:      COVID-19 Vaccine Administration Billing for the Illinois Medicaid Pharmacy Benefits Manager System and the Federal HRSA COVID-19 Reimbursement Program for the Uninsured  

 

 

This notice informs providers of the ability to bill COVID-19 vaccination administration fees through the Illinois Pharmacy Benefits Management System (PBMS) for Illinois Medicaid fee-for-service and the appropriate PBMs for individual HealthChoice Illinois managed care plans.

 

Illinois Medicaid fee-for-service participants and individual HealthChoice Illinois managed care plan participants shall not be turned down for COVID vaccination services when vaccinations are available to be administered at the pharmacy location. Services are to be provided at no cost to the participant.

 

Regardless of income, citizenship, or immigration status, the Health Resources and Services Administration (HRSA) COVID-19 Claims Reimbursement to Health Care Providers and Facilities for Testing, Treatment, and Vaccine Administration for the Uninsured program reimburses providers at Medicare rates for providing COVID-19 vaccine administration, treatment, testing, and testing-related services to uninsured patients. For reimbursement, providers should submit claims to the HRSA COVID-19 Claims Reimbursement Portal. The date of service must be on or after February 4, 2020. Uninsured individuals should not be charged for these services.

Questions regarding this notice may be directed to the Bureau of Professional and Ancillary Services at 877-782-5565 for fee-for-service claims, or to the individual HealthChoice Illinois managed care plan.

 

 

 

Kelly Cunningham, Administrator

Division of Medical Programs​


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JB Pritzker, Governor • Theresa Eagleson, Director