Alerts

Reimbursement for Administration of Hepatitis A Vaccine

1/29/2019

PDF Version

TO:  All Pharmacies, Physicians, Physicians Assistants, Nurse Practitioners, FQHCs and RHCs


In an effort to address the hepatitis A outbreak in our state, effective February 1, 2019 Alabama Medicaid will begin reimbursing Medicaid-enrolled pharmacy providers for the administration of hepatitis A vaccine to eligible recipients age 19 and older. Alabama Medicaid will, in addition to the administration reimbursement, reimburse pharmacies for the hepatitis A vaccine (i.e. ingredient).

  • Beginning February 1, pharmacy providers may bill the following NDC number on a pharmacy claim for reimbursement of vaccine administration:
  •  NDC 99999-9994-11 for hepatitis A administration
  • Reimbursement will be $5 per administration with no dispensing fee or co-pay applied.
  • Claims should be submitted with a dispense quantity of 1 for vaccine administration. There is a maximum quantity for each administration of 1 injection per recipient within a timeframe in accordance with the CDC dosing regimen.
  • A prescription from a recipient’s Primary Medical Provider (PMP) is required for each hepatitis A vaccine administration.
  • To facilitate coordination of care, Pharmacy providers are required to inform (via phone, fax, e-mail, mail) each recipient’s Primary Medical Provider (PMP) upon administration of the vaccine(s) for which an administration claim is submitted. Documentation must be kept on file at the pharmacy of the notification to the PMP. If the PMP is unknown, the pharmacy may call the Alabama Medicaid Automated Voice Response System (AVRS) at 1-800-727-7848 to obtain the PMP information. A suggested Immunization Provider Notification Letter, which can be used to notify the PMP, can be found on the Agency website at
    http://www.medicaid.alabama.gov/content/4.0_Programs/4.3_Pharmacy-DME/4.3.11_Vaccine_Admin.aspx.
  • Alabama State Board of Pharmacy law and regulation should be followed regarding dispensing and administration of legend drugs/vaccines.
  • A separate claim for the vaccine (i.e. ingredient) should be submitted with the appropriate NDC of the vaccine (i.e. ingredient) and will be reimbursed according to the current drug/pharmacy reimbursement policy.


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To facilitate coordination of care, Pharmacy providers are required to inform (via phone, fax, e-mail, mail) each recipient’s Primary Medical Provider (PMP) upon administration of the vaccine(s) for which an administration claim is submitted. Documentation must be kept on file at the pharmacy of the notification to the PMP. If the PMP is unknown, the pharmacy may call the Alabama Medicaid Automated Voice Response System (AVRS) at 1-800-727-7848 to obtain the PMP information. A suggested Immunization Provider Notification Letter, which can be used to notify the PMP, can be found on the Agency website at