MedicaidReimbursementHigh impact
Proposed Rate Changes for Administration of COVID-19 Vaccine
Illinois Medicaid - HFS·IL · Family Medicine, General Practice, Pediatrics +2 more·Provider Notice
Effective date
Jan 1, 2024
We identified it
Jun 20, 2026
Summary
Illinois Department of Healthcare and Family Services changed COVID-19 vaccine administration reimbursement rates effective January 1, 2024. New rates vary by provider type and patient eligibility, with VCP-eligible children receiving $16.71 administration fee and other Medicaid patients having different fee structures depending on provider setting.
Action Required
Immediately: Review all COVID-19 vaccine administration claims with dates of service January 1, 2024 and after - these will be held by the payer until federal approval. For pharmacy claims, either hold claims until administration fee is approved or bill without vaccine administration code and rebill later for full payment. Update billing system with new reimbursement rates once CMS approves the State Plan Amendment.