MedicaidBilling CodesLow impact
Revisions to the Influenza Vaccine Administration Billing Requirements
Illinois Medicaid - HFS·IL · Pharmacy·Provider Notice
Effective date
Dec 1, 2010
We identified it
Jun 21, 2026
Summary
Illinois Medicaid is changing billing requirements for influenza vaccine administration fees effective December 1, 2010. Pharmacies must now submit their usual and customary administration fees in the NCPDP 5.1 Pricing Segment field 438-E3 and use 'MA' in the Professional Service Code field 440-E5.
Action Required
No action required - this is a 2010 policy change that only affects pharmacies billing Illinois Medicaid for influenza vaccine administration. Medical billing teams at healthcare practices are not impacted by these pharmacy-specific NCPDP billing requirements.