Vaccines for Recipients Birth through (18) Years
For eligible recipients from birth through (18) years of age, vaccines and combination vaccines providing protection against the following diseases are available free to the VFC-enrolled provider through the VFC program:
Diphtheria, Tetanus and Pertussis (DTaP)
Haemophilus Influenzae Type b (HIB)
Hepatitis B (pediatric and adult)
Meningococcal Conjugate (MCV4)
Pneumococcal (PCV 7)
Polio (IPV)
Measles, Mumps, and Rubella (MMR)
Tetanus and Diphtheria (Td) (Adult)
Influenza
Varicella
Human Papillomavirus (HPV)
Rotavirus
The following vaccines are available by request or for high-risk areas only through the VFC program:
Hepatitis A
Diphtheria and Tetanus (DT) (Pediatric)
Pneumococcal Polysaccharide (PPV)
Meningococcal Polysaccharide (MPSV4)
Vaccines for Recipients (19) through (20) Years
For eligible recipients ages (19) through (20) years, vaccines and combination vaccines providing protection against the following diseases are reimbursable:
Hepatitis A
Hepatitis B
Human Papillomavirus (HPV)
Influenza
Measles, Mumps, and Rubella (MMR)
Meningococcal Conjugate (MCV 4)
Meningococcal Polysaccharide (MPSV4)
Pneumococcal Polysaccharide (PPV)
Tetanus and Diphtheria (Td)
Varicella
Administration Fee Reimbursement
Medicaid reimburses an administration fee to physicians, ARNPs and Pas providing free vaccines through the VFC Program to Medicaid eligible recipients from birth through (18) years of age
Vaccine Reimbursement
Medicaid reimbursement for providing vaccinations to Medicaid-eligible recipients (19-20) years of age includes the cost of the vaccine and an administration fee.
The provider must bill with the appropriate HCPCS procedure code assigned to the vaccine and a modifier HA when appropriate. CPT codes 90632, 90660, 90733, and 90746 do not require the HA modifier.
