Medicaid Reimbursement of CPT 90480 for Administration of VFC Covid Vaccines

Hi there,

According to the AAP, from their webpage on Reimbursement of Administration of COVID-19 Vaccines through State Medicaid Programs, State Medicaid programs should be reimbursing for the Administration (CPT 90480) of the current COVID vaccines (CPTs 91318-91322 & 91304) at levels at least equal to Medicare payment of $40.00 through 12/31/23, which includes the payment for Administration of VFC COVID-19 vaccines.
In Oregon, I’m aware of only one State Medicaid program (we have many Community Care Organizations) paying for CPT code 90480 for the Administration of VFC COVID-19 vaccines. We have asked for backup from the AAP on this and they are pursuing it, however I am curious what is happening in other states. Are you all being reimbursed by your state Medicaid Programs for the Administration (CPT 90480) for VFC COVID vaccines?

**[AAP’s webpage]
AAP’s webpage on Reimbursement for Administration of COVID Vaccines through Medicaid Programs

Related,
the American Rescue Plan Act (ARPA), signed into law on March 11, 2021, raises
the federal medical assistance percentage (FMAP) for all COVID-19 vaccine
administered to Medicaid and CHIP enrollees to 100% beginning April 1, 2021
through September 30, 2024, thus, making COVID-19 vaccine administration free
to states for these populations. All Medicaid and CHIP programs should
update their fee schedules to pay for the administration of COVID-19 vaccine at
levels at least equal to Medicare payment
. Advocacy through your AAP
chapter may be needed if this is not occurring.