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Evidence Based Clinical Information
The Vaccines for Children (VFC) Program is a federal program that provides free immunizations for children age 0 – 18 years.
ODS does not reimburse for the cost of vaccine serums covered by the VFC Program. Providers should bill ODS only for the administration of the vaccines covered under the VFC Program.
Providers should bill the specific immunization CPT code with modifier 26 or SL, which indicates administration only. Providers should not bill for the administration of these vaccines using CPT codes 90465-90474 or 99211 (immunization administration codes).
ODS is unable to reimburse providers who do not participate in the VFC Program for the cost of the serum. Providers not participating with the VFC Program can direct their patients to the County Health Department to receive the vaccines covered under the program. A County Health Department can bill ODS for the administration of the vaccines.
The following CPT codes are covered under the Vaccines for Children Program:
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1 Age 18 only. 2 All children ages 6-35 months. 3 All children ages 36-59 months and all medically high-risk children ages 60 months through 18 years as defined by the Public Health Immunization Program, including contacts to high-risk household members. 4 Use when 90700 and 90648 are given combined in one injection. 5 All children ages 5 through 18 who are contacts to high-risk household members, as defined by the Public Health Immunization Program. |
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| 906321 | 90633 | 906361 |
| 90645 | 90647 | 90648 |
| 906552 | 906563 | 906572 |
| 906583 | 906605 | 90649 (effective 12/1/06) |
| 90669 | 90700 | 90680 |
| 90707 | 90710 | 90702 |
| 90714 | 90715 | 90713 |
| 907214 | 90723 | 90716 |
| 90733 | 90734 | 90732 |
| 907461 | 90748 | 90744 |