CORRECTION: COVID-19 Vaccine Counseling Under the American Rescue Plan, CR 109388 – PLEASE HOLD ON SUBMITTING CODES

Jun 16, 2022

This is a follow-up to the message we sent on June 13, 2022. Please hold on submitting claims for COVID-19 vaccine counseling until further notice. 

Under the American Rescue Plan Act (ARP), the Centers for Medicare & Medicaid Services (CMS) requires states to cover COVID-19 vaccine counseling visits for families and children under Early and Periodic Screening, Diagnostic and Treatment (EPSDT). MaineCare will cover COVID-19 vaccine counseling services for individuals under 21 years of age, and COVID-19 vaccine counseling will be a MaineCare-covered service under MaineCare Benefits Manual Sections 3, 7, 14, 40, 45, and 90. 

Our previous message regarding how to bill for this service is now out of date. CMS has announced new codes for COVID-19 vaccine counseling visits for families and children, and it will take several weeks for MaineCare to implement the new codes. Please hold your claims for this service until we have implemented the new codes. We will honor claims for this service that providers have already submitted according to the June 13th e-message, and providers do not need to change those claims. 

We will send an update with new billing guidance once we have implemented the new codes. 

If you have questions about COVID-19 vaccine counseling services, please contact your Provider Relations Specialist with questions.