1. Try Super
   Posted 8 months ago #
   

   Medicaid doesn't cover CPT code '99211' as EPSDT code with the flu shot or a vaccine. How are we supposed to bill for any missing vaccine or flu shot that the patient needs? what about the rest of the insurances, are they following the guidelines of medicaid?

2. SuperCoder
   Posted 8 months ago #
   

   The Centers for Medicare and Medicaid Services no longer recognizes CPT® codes 99201, 99211, and 99212 as qualifying EPSDT screens. Codes 99201, 99211, and 99212 are no longer valid for EPSDT screens and should not be billed with modifier EP.

   Other payors follow overall same guidelines, with a detailed instruction in their own payor manual.

3. Try Super
   Posted 8 months ago #
   

   Thanks for the information. I'm still not sure how to bill for the flu shot to Medicaid. Last year we billed it with the EPSDT cpt code ' 99211'. Should we bill as an office vist or w regular EPSDT codes '99391- 99394'? However Medicaid still covers the EPSDT cpt code '99211' with the TB screening reading. Is this going to change as well?
   Thank you so much for your help

4. SuperCoder
   Posted 8 months ago #
   

   For EPSDT: From the range of codes 99381-99384 and 99391-99394, based on new or established pt age-based codes

5. Tanya Ocampo
   Posted 7 months ago #
   

   90741, injection for vaccination & 90742, 2nd injection for vaccination on same DOS

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