Immunization Billing Resources for Public Clinics

Vaccine Eligibility and Billing Codes

• COVID-19 Vaccine CPT Codes
• NEW 317 Vaccine Policy
• Vaccine Eligibility Codes - Public Clinics
• VFC Eligibility Chart
• 317 Eligibility Chart
• Current Vaccine CPT Codes
• OIP State-supplied Administration Fee and Billing Policy
• Flu Coding Flowchart

Vaccine Billables Project

• State of Oregon: Billable Vaccine Invoicing Timeline 2020-22
  • Payment Address and Invoice Request
• Vaccine costs per dose-Jan through Jun 2022
  
• Vaccine costs per dose-July through December 2021
• ALERT IIS - Running Billing Reports
• ALERT IIS - Compatibility View Settings
• ALERT IIS - Update Contact Information
• Credit Request - Request for Vaccine Billable invoice Credit
• Instructions for paying with credit card

DMAP/Medicaid Resources

• DMAP Covered Immunization Table
• Coordinated Care Organizations (CCOs) contact list

Example Tools for Public Health Clinics

The resources listed below are meant to be helpful examples for public clinics to use and edit as needed. Policies and procedures, job descriptions, etc. do not have to match exactly those that are listed here; they are simply meant to be a helpful reference or place to start.

• Billing Policy Example
• Billing Policy Example (Word)
• Marion County - New Private Insurance Billing Procedures
• Marion County - Eligibility Screening Form
• Deschutes County - Immunization Payment Screening Form (Word)
• Deschutes County - Vaccine Coding Flow Chart
• Josephine County - Vaccine Coding Flow Chart
• Model Local Health Department Workflow
• Job descriptions for billing/office staff (in Word)
  • Billing Specialist
  • Enrollment Specialist
  • Enrollment & Billing Specialist
  • Receptionist
• Cost Calculators: Vaccine Administration Fees and Inventory

  Two versions of the tool are available and can be used in Microsoft Excel:

  • Full Version - Includes a more advanced user-interface; requires macros to be enabled in Excel.
  • Simplified version - Can be used without macros and is intended for those without access to Microsoft Excel. If you use a spreadsheet application like LibreOffice or Google Sheets, please use this version.

  For both versions, we suggest you read the Introduction and User Guide carefully before using the tool.

• Vaccine Inventory Value Calculator (Excel)
  This resource can be used to calculate the dollar value of your inventory or to determine the value of all vaccines provided by your agency over a given period of time. This information can be useful when reporting agency services to administrators, county commissioners, or in community health reports.
  
• Family Planning Cost Analysis
  Several health departments are using this tool, provided by the Oregon Reproductive Health Program, to also determine costs associated with immunization services. Scroll down to the "Cost Analysis Training with Gerry Christie" for the manual and webinar presentations.

Medicare Resources

• Medicare Part B: Quick Reference Guide
• Medicare Part D Vaccine Payments

Other Billing Resources

• Immunization Billing Standards
• Independent Insurance Eligibility Verification: A Cost/Benefit Review for Immunization Billing: A Cost/Benefit Review for Immunization Billing. The Arizona Partnership for Immunization
• Parent Information: Where to Get Shots (Word)
• NACCHO Billing Toolkit
  NACCHO's Billing for Clinical Services Toolkit was designed to help make navigating the billing process easier for local health departments. In this toolkit are resources, guides, and templates on all aspects of billing.

Workgroup Presentations and Reports

• Vaccine Administration Fee Presentation (PowerPoint)
• OIP Billable Vaccine Project Presentation
• Billing Survey Report - Executive Summary with Addendum