Date: March 30, 2021
To: Enrolled Physicians, Advanced Practice Nurses,
Physician Assistants, Local Health Departments, Federally Qualified Health Centers,
Rural Health Clinics, Encounter Rate Clinics, and Pharmacies
Re: COVID-19 Vaccine Administration Rate
Increase
This notice provides updated information regarding the
March 15, 2021 Centers for Medicare & Medicare Services (CMS) rate increase
for the administration of COVID-19 vaccines. This guidance applies to claims
for participants covered under both traditional Medicaid fee-for-service and
the HealthChoice Illinois Medicaid managed care plans.
Effective with dates of service on and after March 15,
2021, the Department will continue to follow the rates established for the
Medicare program for reimbursement of the administration fees. Reimbursement
is increased to $42.14 for the administration of each dose of a COVID-19
vaccine.
Department COVID-19 vaccine administration rates for
dates of service prior to March 15, 2021 remain at $16.94 for the initial dose
in a two-dose series, and $28.39 for the second dose in a two-dose series, or
for a single-dose vaccine.
The COVID-19 Fee Schedule has been updated with the new vaccine administration rate.
Providers should refer to the COVID-19 Updates webpage for the most up to date information related to the
COVID-19 public health emergency.
Per CMS, as a condition of receiving free COVID-19
vaccines from the federal government, vaccine providers are prohibited from
charging patients any amount for administration of the vaccine and may not deny
a vaccine to anyone regardless of income, immigration, or insurance status. For
individuals who are uninsured, providers may submit claims for reimbursement of
COVID-19 vaccine administration through the federal HRSA COVID-19 Claims
Reimbursement Portal.
Questions
regarding this notice may be directed to the Bureau of Professional and
Ancillary Services at 877-782-5565.
Kelly Cunningham,
Administrator
Division
of Medical Programs
