MedicaidAdministrativeHigh impact
Vaccines For Children (VFC) Program Changes Effective October 1, 2016
Illinois Medicaid - HFS·IL · Family Medicine, General Practice, Pediatrics·Provider Notice
Effective date
Oct 1, 2016
We identified it
Jun 20, 2026
Summary
Starting October 1, 2016, children with Illinois Title XXI and State-Funded All Kids eligibility are no longer eligible for free VFC vaccines and must have vaccines purchased privately by providers. Providers must verify eligibility status and bill HFS or MCOs directly for vaccine reimbursement using specific billing procedures.
Action Required
Effective October 1, 2016: Billing team must verify All Kids eligibility status through HFS MEDI system or 270/271 transactions to identify Title XXI/State-Funded patients. Purchase vaccines privately for these patients instead of using VFC program. Bill HFS fee-for-service or MCOs directly using clinic's FFS NPI with 'GB' modifier on Form HFS 2360. Document practitioner vaccine orders and administration in medical records. Include NDC codes following Chapter A-200 guidelines. Report non-VFC vaccine costs separately on annual cost reports.