Vaccines for Children (VFC) Program Transition – Billing 317-Funded Vaccines
| To: | Federally Qualified Health Centers (FQHCs), Rural Health Centers (RHCs), and Encounter Rate Clinics (ERCs) |
| Date: | October 14, 2016 |
| Re: | Vaccines for Children (VFC) Program Transition – Billing 317-Funded Vaccines |
This notice provides information regarding the Vaccines for Children (VFC) program. In an effort to ensure Title XXI (21) and State-Funded All Kids eligible children have access to vaccines, the Illinois Department of Public Health (IDPH) is providing Illinois VFC providers the opportunity to order vaccines (317-funded vaccines) through November 26, 2016 or as long as federal funding remains available. Please see IDPH’s notice dated September 30, 2016 for details.
- For vaccines obtained from IDPH through the limited 317 fund supply, clinics must bill the vaccine-specific procedure code as part of a billable encounter (T1015) or as part of a wellness encounter (S5190).
- For private stock vaccines, clinics should bill in accordance with the Vaccination Billing Instructions for Encounter Rate Clinics Only posted on the Non-Institutional Providers webpage.
For participants enrolled in one of the Medicaid Managed Care Organizations, providers should contact the individual plan for billing policies and procedures, as well as reimbursement information.
Providers must maintain appropriate documentation in their records to be able to provide in the event of an audit.
Additional information specific to the VFC program changes are located on the Non-Institutional Providers webpage.
Questions regarding this notice should be directed to a Medical Assistance Consultant in the Bureau of Professional and Ancillary Services at 1-877-782-5565.
Felicia F. Norwood
Director
