NEW YORK TIMES CORONA TRACKER CODE
When billing for COVID-19 administration, do you want to see both the zero dollar vaccine (91300) and the administration code (0011A) on the claim, or just the administration code?īoth the vaccine code and the administration code need to be on the claim form and the NDC will apply to the vaccine code. The NDC should be on the vaccine line of the claim. The NDC should come from the vaccine packaging. If NDC is on the admin code would you expect to see this in the same loop we normally send the NDC number? Both codes have to be present for the claim to process. IME needs to see both the NDC number and the administration code. We normally include the NDC number on the vaccine code, but it is mentioned in the IL that you want to see the NDC number on the administration code so that leads me to believe you only want to see the admin code and not the zero dollar vaccine, correct? The costs for the vaccine administration would be included, as reimbursable costs, on the annual cost report and will be part of the cost settlement. If there is not a billable face-to-face encounter and the member is Medicaid only, there is nothing billable. If the vaccine administration is the only service provided, and can be billed separately (outside of the encounter rate), would you expect to see Place of Service (POS) code 11 or 72 on the claim?
As instructed in IL 2214, if the patient has Medicare or another payor resource, the vaccine administration fee should be filled to that resource. If the only service the patient is receiving is the vaccine administration, because there is no face-to-face visit with the Rural Health Clinic (RHC)/Federally Qualified Health Center (FQHC) provider this service not reimbursable, so would we file the cost report?
2207-MC-FFS-CVD for more details regarding Medicaid billing guidance for the COVID-19 vaccine and monoclonal antibodies. Send questions to to Informational Letter (IL) No.
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