Originally published December 22, 2020
Updated on January 6, 2021
This is the second article in the COVID-19 Vaccine Administration series. With the recent federal approval of COVID-19 vaccines, the Department of Health Care Services (DHCS) is seeking federal approval to help support delivery of the vaccine to all Medi-Cal beneficiaries.
Effective November 2, 2020, Qualified Providers (QPs), who are also registered with the California Department of Public Health as a COVID-19 Vaccination Provider, can be reimbursed for the COVID-19 vaccine through the COVID-19 Uninsured Group Program.
QPs should refer to the previously published article titled “COVID-19 Vaccine Administration: Initial and Upcoming Policy,” for specific billing instruction and policies regarding the reimbursement for the administration of the COVID-19 vaccine.
Additionally, as a reminder, individuals who have a Medi-Cal Share of Cost (SOC), and have not met their SOC obligation, are eligible for the COVID-19 Uninsured Group Program if all other eligibility criteria are met. The COVID-19 Uninsured Group program provides temporary, no cost diagnostic testing, testing-related services, hospitalization and other treatment and vaccination services, including all medically necessary care, which includes associated office, clinic, or emergency room visits related to COVID-19. This program is available to uninsured and underinsured individuals determined eligible by a QP based on preliminary applicant information. Providers should refer to the COVID-19 Uninsured Group’s Frequently Asked Questions for more information.
QPs of the PE4PW, BCCTP, HPE, or CHDP Gateway programs will have access to the COVID-19 Uninsured Group Application Portal.
To access the COVID-19 Uninsured Group Application Portal, follow the instructions below:
- Access the Medi-Cal website at https://www.medi-cal.ca.gov/, select “Providers” and click the “Transactions” link.
- Enter your User ID (National Provider Identifier) and Password (Provider Identification Number) and click the “Submit” button.
- Click the “Prgms” tab.
- Click the “COVID-19 Uninsured Group Eligibility” link.
Questions
For billing related questions, please contact the Telephone Service Center (TSC) at 1(800) 541-5555. The TSC is available 8 a.m. to 5 p.m., Monday through Friday, except holidays (border providers and out-of-state billers billing for in-state providers, call [916] 636-1200).
For other general questions concerning the COVID-19 Uninsured Group program, please direct your inquiry to COVID19Apps@dhcs.ca.gov.