MedicaidBilling CodesMedium impact
Medicaid Alert - MA-2009-04
New Jersey Medicaid·NJ · Allergy & Immunology, Family Medicine, General Practice +2 more·Eligibility
Effective date
Oct 1, 2009
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid is establishing reimbursement rates and billing codes for H1N1 influenza vaccine administration through the Vaccines for Children (VFC) program. Billing teams must use specific HCPCS codes (G9141 for injection, G914152 for nasal spray) with corresponding reimbursement rates ($11.50 and $5.00 respectively) for Medicaid/NJ FamilyCare fee-for-service beneficiaries. This policy is effective immediately.
Action Required
Immediately: Billing team must update billing software to recognize and process HCPCS codes G9141 (H1N1 injection vaccine administration - $11.50 reimbursement) and G914152 (H1N1 nasal spray vaccine administration - $5.00 reimbursement) for all Medicaid/NJ FamilyCare fee-for-service claims. Update encounter templates and provider documentation to ensure correct code selection based on vaccine administration route. Staff administering or billing for H1N1 vaccines must be notified of these specific codes and rates. Retain this alert for reference during billing audits and claims processing. Failure to use correct codes may result in claim denials or payment at incorrect rates.