Medicaid: Increased payment for office visits and vaccine administration

Tuesday, January 06, 2015 06:38 AM

Beginning Jan. 1, 2015, the Colorado Medical Assistance Program (Medicaid) will reimburse covered office visit procedure codes (E&M codes) and the vaccine administration procedure codes for all providers at a rate equal to 100% of Medicare’s December 2014 reimbursement rate. The new rate will be available to all enrolled providers that submit fee schedule claims for office visits or vaccine administrations. The new reimbursement rate will be in place until June 2016.

Please note that this rate increase is not a continuation of the previous 1202 Primary Care Supplemental quarterly payments. This increase does not require providers to attest to providing primary care and the higher rate is paid for each claim submitted. Please also note that Medicaid will not be changing its reimbursement for E&M codes on a quarterly basis, as Medicare does. E&M codes will be paid at the December 2014 Medicare rate, regardless of whether Medicare raises or lowers its reimbursement of these codes over the coming months.