COVID-19 Vaccine Billing and Vaccine Codes

COVID-19 providers agree to administer vaccine regardless of an individual’s ability to pay and regardless of their coverage status, and may not seek any reimbursement, including through balance billing, from a vaccine recipient. 

Reimbursement Guidance

• Michigan Medicaid Bulletin re: Medicaid Reimbursement of COVID-19 Vaccine Services
  • Rates also available in CHAMPS
  • All reimbursement rates will be reviewed and updated as applicable and are published on the MDHHS website at www.michigan.gov/medicaidproviders >> Billing & Reimbursement >> Provider Specific Information.
• CMS Coverage Announcement 
  • Summary of Medicare, Medicaid, Private insurers, uninsured
• CMS Toolkits for Provider Support
• Uninsured/Underinsured Reimbursement via Provider Relief Fund
• American Pharmacists Association "Reimbursement for Administration of COVID-19 Vaccines"

Code Sets

• MCIR Vaccine Code Set
• CDC Vaccine Codes and Crosswalk
  • CPTs, NDCs, CVXs (Codes will become effective only upon EUA issuance)