MedicaidCoverageMedium impact
Copayment No Longer Required for Specified Preventive Services and Adult Vaccines
Wisconsin Medicaid (ForwardHealth)·WI · Family Medicine, General Practice, Internal Medicine +2 more·Medical Policy
Effective date
Jan 1, 2014
We identified it
Jun 20, 2026
Summary
Effective January 1, 2014, Wisconsin Medicaid and BadgerCare Plus eliminated copayments for USPSTF A/B rated preventive services and ACIP-recommended adult vaccines. Billing teams must use modifier 33 for preventive services that aren't specifically identified as preventive to ensure no copayment is deducted.
Action Required
By January 1, 2014: Billing team must stop collecting copayments for USPSTF A/B rated preventive services and ACIP adult vaccines for Wisconsin Medicaid and BadgerCare Plus members. Add CPT modifier 33 to preventive services not specifically identified as preventive (excluding CPT codes 99385-99387 and 99395-99397 which are automatically exempt). Update billing system rules and train staff on copayment exemptions.