MedicaidBilling CodesHigh impact
COVID-19 Vaccine Administration Performed in Hospital-Based Outpatient Settings
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Mar 15, 2021
We identified it
Jun 20, 2026
Summary
Hospital-based outpatient COVID-19 vaccine administration must now be billed using 837 Professional claim format instead of institutional claims, with specific rendering provider requirements. Reimbursement rates increased to $42.14 for all vaccine administration codes effective March 15, 2021.
Action Required
Immediately: Hospital billing teams must void previously submitted institutional claims for COVID-19 vaccine administration and rebill using 837 Professional format. Use Medical Director or Chief Medical Officer NPI as rendering provider (must be registered in IMPACT). Update billing system to use new rates: $42.14 for all administration codes effective 3/15/2021. Ensure billing provider information is linked to rendering provider NPI.