Home Health Agency Providers May Be Reimbursed for COVID-19 Vaccine Administration

February 8, 2022

Effective retroactively for dates of service on or after the respective dates for each approved COVID-19 vaccine, Home Health Agency Services and Home and Community-Based Services providers may receive reimbursement for administration of the coronavirus disease 2019 (COVID-19) vaccines. Refer to the webpages below for billing guidance and effective dates for each vaccine:

Effective until June 30, 2022, Medi-Cal will waive the timeliness standard for vaccination administration claims by Home Health Agency providers when claims are submitted or resubmitted with the following:

  • Delay Reason Code “10”

  • Documentation indicating that the COVID-19 vaccine was administered by a Home Health Agency provider in the Remarks area of the submitted claim (for example, “COVID Vaccine administration by Home Health Agency Provider”)

An Erroneous Payment Correction (EPC) will be implemented to reprocess any previously denied claims that were submitted by Home Health Agency providers for the administration of an applicable COVID-19 vaccine. Providers may also elect to use this updated billing policy to correct and resubmit previously denied claims as described earlier in this article.