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.

• Transmittal 20-45 - COVID-19 Vaccine Administration Rate and Billing Codes
• Transmittal 20-41 - COVID-19 Testing Lab Billing & Reimbursement Update
• Transmittal 20-31 - COVID-19 ICD-10 Updates for Hospitals
• Transmittal 20-21 Hospital Billing Codes and Reimbursement Rates for COVID-19 Services 

Eligibility 

• Transmittal 20-10 (rev.) Temporary Eligibility Policy Changes for Medicaid, Children’s Health Insurance Program (CHIP), Alliance, and Immigrant Children’s Programs in Response to Public Health Emergency (PHE) COVID-19

• Transmittal 20-20 (Rev.) COVID 19 LTC Application Telephonic Signature Process

• Transmittal 20-10 Temporary Eligibility Policy Changes for Medicaid, Children’s Health Insurance Program (CHIP), Alliance, and Immigrant Children’s Programs in Response to Public Health Emergency COVID-19 

Behavioral Health

• Transmittal 20-36 Temporary Enhanced Reimbursement Rates for Adult Substance Abuse Rehabilitation Services (ASARS) Due to COVID-19

FQHC

• Transmittal 20-32 - FQHC PMPM during COVID 19

Provider Enrollment 

• Transmittal 20-14 Temporary Provider Screening and Enrollment Flexibilities in Response to the COVID-19 Public Health Emergency 

​Pharmacy Services 

•  Transmittal 20-16 Temporary Pharmacy Program Changes Due to COVID-19 

Telemedicine 

• Transmittal 20-37 Delivering Psychosocial Rehabilitation Clubhouse Services via Telemedicine

• Transmittal 20-28 Billing for Telemedicine Encounters

• Transmittal 20-27 Temporary Enhanced Reimbursement Rates for Assisted Living Facilities Due to COVID-19

• Transmittal 20-23 Billing for Teledentistry Encounters 

• Transmittal 20-08- Public Health Emergency Guidance on Medicaid-Reimbursable Telemedicine Services Allowance for Audio-Only Visits and HIPAA 

• Transmittal 20-07-Medicaid-Reimbursable Telemedicine Services: Reimbursement for Healthcare Services Delivered to a Beneficiary in their Home via Telemedicine Documents 

• General Telemedicine Guidance 

Long Term Support Services 

• Transmittal 20-19 (rev. #2) – HHA & ADHP Waiver Services COVID-19 Enhanced Rates 

• Transmittal 20-18 Temporary Enhanced Reimbursement Rates for District ICFIID Due to COVID-19 

• Transmittal 20-17 Temporary Enhanced Reimbursement Rates for District Nursing Homes Due to COVID-19 

• Informational Bulletins for LTC Providers 

CMS Waivers & Amendments 

• Section 1135 Waiver Requests to Assist Healthcare Providers in Responding to COVID-19 

• Medicaid Update: CMS Approves 1915 (c ) HCBS Waiver Appendix K Emergency Preparedness Response Plan 

Public Health Emergency

• Medicaid Director Letter - Frequently Asked Questions Related to DHCF Operations After the Conclusion of the COVID-19 Public Health Emergency