CMS Says Children’s COVID-19 Vaccine Counseling Visits Covered by Medicaid



MM Curator summary

[ MM Curator Summary]: CMS will now require COVID vaccination counseling as part of the EPSDT program.


The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.


On Dec. 2, the Centers for Medicare & Medicaid Services (CMS) announced that Medicaid programs must cover COVID-19 vaccine counseling visits provided to children as part of the Medicaid Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit. This action is part of the Biden-Harris administration’s winter plan to respond to COVID-19 amid the emergence of a new variant of concern, omicron.

COVID-19 vaccine counseling visits will fall under COVID-19 vaccine administration, and as such will be federally matched at 100% under the American Rescue Plan Act. The law was enacted in March 2021 and provides a 100% federal match for COVID-19 vaccines and vaccine administration during the public health emergency and for one year after the end of the emergency. Read more about the American Rescue Plan Act’s health-related provisions in this previous blog post.

Medicaid programs will also be required to cover stand-alone vaccine counseling visits, federally matched at the regular match rate, for all pediatric vaccines under the EPSDT benefit.


Clipped from: