Is the administration fee based on per shot or per antigen?
Providers bill according to CPT codes that are based on each vaccine (type of immunization) administered. Reimbursement through Medicaid varies by state. Some state Medicaid agencies reimburse a vaccine with multiple antigens at a higher rate than a single antigen vaccine. Some states limit the amount of administration fees reimbursed per visit. Please check with the stateMedicaid agency to determine how the VFC administration fees are reimbursed. State Medicaid agencies cannot eliminate reimbursement of an administration fee because of how the vaccine is administered (i.e. injection versus orally administered). For non-Medicaid VFC eligible children (i.e., Alaska Natives/Native Americans, uninsured and underinsured) the administration fee is based on vaccine dose (shot) not the number of antigens contained in a vaccine dose (shot). The administration fee charged to a non-Medicaid VFC eligible child cannot exceed the maximum regional charge except in universal-purchase states and then
