MedicaidBilling CodesMedium impact
COVID-19 Vaccine Counseling-Only for Pediatric Members pdf
Connecticut Medicaid (HUSKY Health)·CT · Family Medicine, Internal Medicine, Pediatrics +1 more·Provider Bulletin
Effective date
Apr 1, 2021
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid (HUSKY Health) now reimburses COVID-19 vaccine counseling-only visits for members under age 21 as part of EPSDT benefits. Providers must use CPT 99401 with modifier SC for separate billing, but cannot bill counseling separately when vaccine is administered during the same visit.
Action Required
Immediately: Billing team must configure system to bill CPT 99401 with modifier SC for COVID-19 vaccine counseling-only visits for HUSKY Health members under age 21. Update billing rules to prevent separate counseling billing when vaccine is administered same day. Train staff that counseling must be billed under child's ID even when provided to parents/guardians. Add modifier 25 when billing counseling same day as other E&M services.