News and Information

News & Information

Novel H1N1 Vaccine Policy

Utah Medicaid providers coverage for the seasonal influenza vaccine through pharmacies or physicians' offices for clients enrolled in the Traditional Medicaid (purple card) program. Clients enrolled in the Non-Traditional (blue card) and PCN (yellow card) programs may receive seasonal influenza vaccines only through physicians' offices. Additionally, Utah Medicaid will provide coverage for the H1N1 influenza vaccine through pharmacy providers in all 3 programs (Traditional, Non-Traditional, and PCN). Medical Providers should bill for the H1N1 influenza vaccine using CPT Code 90663 for the vaccine and 90470 for the administration. This is not a VFC vaccine, and providers should not use the SL modifier. Providers should NOT USE the CPT codes for seasonal influenza vaccine when administering H1N1 vaccine.

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