CMS releases Stand-alone Vaccine Counseling-specific HCPCS codes

View in browser | Distributed by Center for Medicaid and CHIP Services (CMCS) Today, the Centers for Medicare & Medicaid Services (CMS) released stand-alone Medicaid & Children’s’ Health Insurance Program (CHIP) vaccine counseling Healthcare Common Procedure Coding System (HCPS) codes.  As mentioned in State Health Official Letter #22-002 “Medicaid and CHIP Coverage of Stand-alone Vaccine Counseling”, CMS created these new HCPCS codes so that providers may use them to bill for stand-alone vaccine counseling.  This includes COVID-19 stand-alone vaccine counseling codes for counseling provided to Medicaid and CHIP beneficiaries who are eligible both for Early and Periodic Screening, Diagnosis and Treatment (EPSDT) provisions and the COVID-19 vaccination coverage required under the American Rescue Plan.  These codes can be used for stand-alone vaccine counseling provided in-person and/or via telehealth. The codes and descriptors are included below. For more information on Medicaid and CHIP coverage of stand-alone vaccine counseling, please see the letter to states here. New Vaccine Stand-alone Counseling Codes G0310  Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service, 5 to 15 mins time. (This code is used for Medicaid billing purposes.) G0311 Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service, 16-30 mins time. (This code is used for Medicaid billing purposes.) G0312  Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service for ages under 21, 5 to 15 mins time. (This code is used for Medicaid billing purposes.) G0313 Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service for ages under 21, 16-30 mins time. (This code is used for Medicaid billing purposes.) G0314    Immunization counseling by a physician or other qualified health care professional for COVID-19, ages under 21, 16-30 mins time. (This code is used for the Medicaid Early and Periodic Screening, Diagnostic, and Treatment Benefit (EPSDT). G0315   Immunization counseling by a physician or other qualified health care professional for COVID-19, ages under 21, 5-15 mins time. (This code is used for the Medicaid Early and Periodic Screening, Diagnostic, and Treatment Benefit (EPSDT).   Stay connected with Medicaid.gov and CMS: