MedicaidReimbursementMedium impact
Vaccine Administration- Vaccines in the Vaccines For Children (VFC) Program
Illinois Medicaid - HFS·IL · Family Medicine, Pediatrics, General Practice·Provider Notice
Effective date
Sep 30, 2013
We identified it
Jun 20, 2026
Summary
This policy clarifies that VFC vaccine administration claims must use the vaccine product CPT code but bill at the usual and customary charge for the administration service. Providers who previously under-billed can void and rebill claims from January 1, 2013 through December 31, 2014 to receive full ACA enhanced payments.
Action Required
Review historical VFC vaccine administration claims from January 1, 2013 through December 31, 2014. If you billed below your usual and customary administration charge, void and rebill those claims using the vaccine product CPT code but at your full U&C administration fee amount. Follow void and rebill instructions in Chapter 300 of the Provider Handbook. Contact Bureau of Comprehensive Health Services at 1-877-782-5565 option 3 then option 1 with questions.