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MedicaidReimbursementMedium impact

COVID-19 Vaccine Administration Rate Increase

Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Mar 15, 2021
We identified it
Jun 20, 2026
Days to comply

Summary

COVID-19 vaccine administration reimbursement increased to $42.14 per dose for dates of service on or after March 15, 2021, up from the previous tiered rates of $16.94 and $28.39. This applies to both traditional Medicaid fee-for-service and HealthChoice Illinois Medicaid managed care plans.

Action Required

Action needed
Immediately: Billing team must update billing system to reflect new COVID-19 vaccine administration rate of $42.14 per dose for all Medicaid claims with dates of service March 15, 2021 and after. Update fee schedules and verify claims are billing at the correct rate. Continue using previous rates ($16.94 for initial dose, $28.39 for second dose or single-dose) for services prior to March 15, 2021.