Vaccine Counseling Services are Reimbursable using E&M Office or Other Outpatient Visit CPT codes

March 18, 2022

California recognizes the importance of vaccinating all Medi-Cal beneficiaries against infectious diseases, including COVID-19.  Vaccine counseling can reduce vaccine hesitancy by allowing beneficiaries to consult with and receive vaccine information directly from their regular physician or medical practitioner.  Medi-Cal reimburses vaccine counseling services when a beneficiary does not receive the vaccine from the same provider on the same date of service.  Physicians or Outpatient providers may report vaccine counseling-only services to Medi-Cal by using the most appropriate Evaluation and Management (E&M) Office or other Outpatient visit CPT® code, along with one of the following ICD-10-CM diagnosis codes: Z28 – Z28.9 or Z71.85.