Vaccine Administration Codes Reimbursement Update

Vaccine administration code changes effective Aug. 1.

Effective Aug. 1, 2022, vaccine administration codes 90471, 90472, and 90474 will no longer be reimbursed at an Off Campus-Outpatient Hospital (POS 19) or an On Campus – Outpatient Hospital (POS 22) place of service. 

According to CMS, place of service 19 and place of service 22 indicate that a service was performed in a hospital-owned facility, therefore physicians cannot be reimbursed for services that are provided by staff of a hospital/facility. In order for a physician to bill Medicaid for a service, that service must represent a cost to the physician.  

Contact

NC Medicaid Contact Center, 888-245-0179

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