Effective, March 1, pharmacy providers are now able to bill all vaccines which are listed on the Centers for Disease Control and Prevention (CDC) Immunization Schedules via NCPDP D.0 pharmacy claims for fee-for-service (FFS) and MSCAN beneficiaries. Also, reimbursement has changed in that vaccine administration fees, equal to those paid to primary care providers, will be paid instead of professional dispensing fees. PCP vaccine administration fees can be found on the Division of Medicaid’s (DOM) Fee Schedule and Rates Website page on the ‘Increased Primary Care Provider’ fee schedule tab.
These changes apply to beneficiaries aged 19 and over and vaccines administered to beneficiaries aged 10 through 18 must be administered by pharmacy providers who are enrolled in the Vaccines for Children (VFC) program. Further guidance will be issued for this age group at a later date.
Also in Mississippi, the Division of Medicaid published a final rule to amend regulations under Title 23, Part 224, Chapter 1, to provide for coverage of vaccine administration by pharmacists. The rule is effective April 1, 2021.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.