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The South Carolina Department of Health and Human Services has released coverage policy for H1N1 flu administration. As of October 1, 2009, reimbursement will be provided for administration of the H1N1 vaccine. The policy for flu vaccination is being expanded this year to include H1N1 in addition to one seasonal flu vaccination. Multiple doses will be covered. The H1N1 vaccine is not being provided as a Vaccine Assurance for All Children (VAFAC) covered procedure. It will not count toward the three per day limit.
For influenza A (H1N1) administration, providers should bill: 90470 – H1N1 immunization administration (intramuscular, intranasal).Seasonal influenza services should continue to be billed following current policy. The vaccine is being provided by the federal government free of charge. Information about vaccine distribution can be found on the CDC website.
When billing for vaccines that are not covered under the VAFAC program or the beneficiaries are over age 19, the provider may bill for the vaccine and the administration code using 96372. Administration of vaccines covered under the VAFAC program should be billed using 90471-90474.
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