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​
