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Immunization Fee Schedule Updates: 2024-2025 Influenza Vaccines and VFC (IB24-42 revised 11.19.24)

Date: 11/21/24

Louisiana Healthcare Connections is sharing a publication on update to the 2024-2025 Influenza Vaccines and VFC Immunization Fee Schedule (IB24-42) was revised on November 19, 2024. Revision language is in bold.

Louisiana Medicaid has updated the following immunization fee schedules to reflect recent changes which include coverage of the influenza vaccines for recipients of all ages and changes related to Vaccines for Children (VFC).

  • Children/Adolescents: (birth through age 18)  
  • Young Adult: (ages 19 and 20 years)  
  • Adult: (ages 21 years and older)  

For easy identification, changes are noted in blue font within each applicable fee schedule (both current and previous). The fee schedules can be found on the Louisiana Medicaid website.

Immunization Coverage Added/Updated Effective for Dates of Service (DOS) On and After August 1, 2024

  • 90611 has been added to VFC for beneficiaries age 18 years old. VFC claims reimburse at $0.  
  • 90653 has been added for beneficiaries ages 65-99 years old and will reimburse at $83.49. 
  • 90656 – the fee has been updated to $22.35. . Reference Informational Bulletin 24-45 for updates related to the influenza trivalent (IIV3) vaccine administered to children.
  • 90657 has been added for beneficiaries ages 19-99 years old and will reimburse at $10.93. 
  • 90658 – the fee has been updated to $21.86. 
  • 90660 has been added to VFC for children ages 6 months through 18 years old. VFC claims reimburse at $0. Recipients ages 19-49 will reimburse at $28.87. 
  • 90661 has been added to VFC for children ages 6 months through 18 years old. VFC claims reimburse at $0. Recipients ages 19-99 will reimburse at $36.85. 
  • 90662 has been added for beneficiaries ages 65-99 years old and will reimburse $83.49. 
  • 90673 has been added for beneficiaries ages 19-99 years old and will reimburse at $83.49. 

Vaccines for Children Coverage 

  • VFC coverage ended for the following codes effective August 1, 2024:  90649     90672     90674     90685     90686     90687     90688 

Correction

  • 90480 – the published rate has been corrected. Claims have reimbursed correctly at $30.78 for DOS on and after January 1, 2024. 

Louisiana Healthcare Connections will update our system to reflect the changes above within 30 days of this notification (Section 2.18.9.5 of the contract). Claims will be automatically recycled once systems have been updated. No action is needed by providers.

Questions related to fee-for-service claims should be directed to Gainwell Technologies Provider Relations at (800) 473‐2783 or (225) 924‐5040. 

Providers with questions regarding managed care claims can contact Provider Services at 1-866-595-8133.