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MEDICAID COVID-19 PROVIDER UPDATES

COVID-19​ Testing and Vaccine Administration

DC Health has developed provider toolkits to assist you in counseling and educating patients about the benefits and risk of COVID-19 vaccination. The toolkit and other related COVID-19 vaccination materials are available at coronavirus.dc.gov/vaccine.  Additionally, there are a number of COVID-19 vaccination training program materials for healthcare professionals that can be accessed via web by you and your staff. These training modules also include modules that are specific to the Pfizer-BioNTech and Moderna vaccines and can be accessed at train.org/main/training_plan/4870

For more information on the District’s Vaccination Program phases and tiers visit coronavirus.dc.gov/vaccine

DHCF is committed to taking critical steps to ensure DC Medicaid and Alliance beneficiaries have access to COVID-19 testing and vaccinations.

The links below provide additional guidance on the most current billing and reimbursement guidance for all COVID-19 testing and vaccine administration codes covered by DHCF. DHCF has committed to paying the same rate as Medicare for COVID-19 testing and vaccinations. Managed Care Organizations (MCOs) are required to reimburse providers at or above the rates published in the transmittals below. Providers should follow instructions provided by the beneficiary’s MCO for billing for COVID-19 testing and vaccine administration.

As a reminder counseling and education for vaccination is a reimbursable Medicaid service and is deliverable via telemedicine, under both fee-for-service and managed care delivery systems. As part of routine primary care or evaluation and management (e.g. CPT codes 99201-99205, 99211-99215 as applicable), physicians and other qualified providers are able to counsel and educate their patients to support medical treatment. Advising patients on the benefits of the COVID-19 vaccine is a billable service and will be vital in ensuring high vaccination rates in the District.

Eligibility 

Behavioral Health

FQHC

Provider Enrollment 

​Pharmacy Services 

Telemedicine 

Long Term Support Services 

CMS Waivers & Amendments 

Public Health Emergency