CCHAP Practice Manager Newsletter: Vaccine Administration Rate Increase

“Vaccine Administration Rate Increase:  Effective January 1, 2015, the General Assembly approved an increase to the rate for vaccine administration. The new rate is 100% of the maximum rate for Colorado, set by DHHS.

The rate for vaccine administration codes 90460, 90471, and 90473 is now $21.68, an increase of more than 300% from the previous rate of $6.59. The federal law creating the Vaccines for Children Program also mandated that DHHS cap fees for vaccine administration. Each state has a different cap. Colorado’s fee cap is $21.68.

Providers will receive the new rate through a mass adjustment, unless their submitted charge is less than the new rate, $21.68. Any claim with a submitted charge lower than the revised rate must be adjusted by the provider. It is recommended that providers submit charges based on Usual and Customary rates, when applicable.

Read the Colorado Children’s Healthcare Access Program’s (CCHAP) full newsletter for more information on:

• Vaccine Access Task Force Update (SB 222)
• Next CCHAP Practice Manager Meeting
• Medicaid Provider Revalidation Requirement
• Diabetes Self-Management Education Coverage
• ICD-10 Update from Medicaid
• Cavity Free at Three Training Opportunity

Also available is their July 9th Clinical Newsletter.” [Source: CCHAP]