MedicaidCoverageMedium impact
Newsletter Vol. 10, No. 81
New Jersey Medicaid·NJ · Pediatrics, Family Medicine·Provider Notice
Effective date
Oct 1, 2000
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid now covers the administration fee for pneumococcal conjugate vaccine (PREVNAR) for eligible children. Providers can bill $11.50 administration fee using CPT codes 90471 or 90472, and can obtain the vaccine through the federal VFC program.
Action Required
Effective October 1, 2000: Billing team must update system to bill CPT 90471 for single pneumococcal conjugate vaccine injection or CPT 90472 when given as additional injection on same date. Use Form MC-19 when vaccine is given with EPSDT/HealthStart visits. Contact DHSS to obtain vaccine doses per June 1999 newsletter procedures.