--- title: "​COVID-19 Vaccine: Update on Vaccination Counseling Code Reimbursement  ​" description: "On July 9, 2021, an addendum to COVID-19 Bulletin #168 was released in SPECIAL BULLETIN COVID-19 #170: Update on Vaccination Counseling Code Reimbursement. Read highlights on the blog." image: https://go.northwestahec.wakehealth.edu/hubfs/Events%202020/covidvaccine.jpg --- [![nwahec.png](https://go.northwestahec.wakehealth.edu/hs-fs/hubfs/WFUSM_NWAHEC%20Cobranding%20Logo_H_RGB.png?width=2025&height=300&name=WFUSM_NWAHEC%20Cobranding%20Logo_H_RGB.png "nwahec.png")](https://go.northwestahec.wakehealth.edu/) - [Home](https://go.northwestahec.wakehealth.edu) - [What's New at NWAHEC Blog](https://go.northwestahec.wakehealth.edu/blog) - [NWAHEC Staff](https://go.northwestahec.wakehealth.edu/staff) - [Practice Support Updates](https://go.northwestahec.wakehealth.edu/practicesupport) # Practice Support Update Blog ## [​COVID-19 Vaccine: Update on Vaccination Counseling Code Reimbursement  ​](https://go.northwestahec.wakehealth.edu/practicesupport/covid-19-vaccine-update-on-vaccination-counseling-code-reimbursement) Jul 14, 2021 4:30:00 PM / by [Practice Support Team](https://go.northwestahec.wakehealth.edu/practicesupport/author/practice-support-team) - [Tweet](https://twitter.com/share) On July 9, 2021, an addendum** to** [COVID-19 Bulletin #168](https://medicaid.ncdhhs.gov/blog/2021/06/21/special-bulletin-covid-19-168-vaccination-counseling-code-reimbursement) was released in [SPECIAL BULLETIN COVID-19 #170: Update on Vaccination Counseling Code Reimbursement](https://medicaid.ncdhhs.gov/blog/2021/07/09/special-bulletin-covid-19-170-update-vaccination-counseling-code-reimbursement). Read highlights below.  Effective June 22, 2021, CPT 99401: *Preventative medicine counseling and/or risk factor reduction intervention(s) provided to an individual, up to 15 minutes* has been added to counsel Medicaid beneficiaries regarding the benefits of receiving the COVID-19 vaccine.    ![covidvaccine](https://go.northwestahec.wakehealth.edu/hs-fs/hubfs/Events%202020/covidvaccine.jpg?width=300&name=covidvaccine.jpg)CPT 99401 can be billed at only one visit for each beneficiary per day, but there are not quantity limits for the number of times this education can be provided to an individual beneficiary. Counseling may be provided in person, via live audio/video (telehealth) or telephonically. Additionally, this service can be billed by multiple providers and can be billed multiple times on different days.  Providers must bill CPT 99401 with a CR modifier to indicate a PHE code. There is no requirement for a specific diagnosis code. The following coding criteria will apply:  - Requires 25 modifier if in addition to OV E&M, if applicable  - Requires CR and GT modifiers if provided via telehealth  - Requires CR and KX modifiers if provided telephonically  Providers are encouraged to counsel Medicaid beneficiaries of any age. Parents can be counseled about giving the vaccine to their children age 12 and over. Parents or guardians of Medicaid children can be counseled on the benefit of receiving the COVID-19 vaccination even if the parent or guardian is not enrolled in NC Medicaid. The counseling session for the parent or guardian can be billed to the child’s Medicaid ID, but only one code can be billed per day.  This service can only be provided by MD/DO, NP, PA, CNM and, if provided at LHD, FQHC or RHC by one of these professionals, will be reimbursed outside of the PPS rate. Reimbursement is relative value units (RVU) based and ranges from $20.68 – $24.54 for Facility and from $32.28 – $38.30 for Non-Facility. This coverage is time-limited, initially for three months to end on Sept. 22, 2021, and will be reevaluated throughout the PHE. For more information on the rates, please refer to the applicable Fee Schedule listed below.  - [Physician Services](https://medicaid.ncdhhs.gov/providers/fee-schedules/physician-services-fee-schedules) - [Nurse Practitioner](https://medicaid.ncdhhs.gov/providers/fee-schedules/nurse-practitioner-fee-schedules) - [Nurse Midwife](https://medicaid.ncdhhs.gov/providers/fee-schedules/nurse-midwives-fee-schedules) - [Physicians Services E&M](https://medicaid.ncdhhs.gov/providers/fee-schedules/physician-services-fee-schedules) - [Physician Assistant E&M](https://medicaid.ncdhhs.gov/providers/fee-schedules/physician-assistant-fee-schedules) - [Nurse Practitioner E&M](https://medicaid.ncdhhs.gov/providers/fee-schedules/nurse-practitioner-fee-schedules) - [FQHC](https://medicaid.ncdhhs.gov/providers/fee-schedules/federally-qualified-health-centers-fqhc-fee-schedules) - [RHC](https://medicaid.ncdhhs.gov/providers/fee-schedules/rural-health-clinic-rhc-fee-schedules)   Contact  NCTracks Contact Center: 800-688-6696      Tags: [COVID-19](https://go.northwestahec.wakehealth.edu/practicesupport/topic/covid-19), [Vaccines](https://go.northwestahec.wakehealth.edu/practicesupport/topic/vaccines) ![Practice Support Team](https://go.northwestahec.wakehealth.edu/hs-fs/hubfs/CircleNWAHEC-2022-3.png?width=100&height=100&name=CircleNWAHEC-2022-3.png) #### Written by [Practice Support Team](https://go.northwestahec.wakehealth.edu/practicesupport/author/practice-support-team) This is a search field with an auto-suggest feature attached. - There are no suggestions because the search field is empty. ### Practice Support Services Health care practices in North Carolina face many challenges. 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[winter (1)](https://go.northwestahec.wakehealth.edu/practicesupport/tag/winter) See all ### In Case You Missed It... Check Out These Recent Posts # About Us The Northwest Area Health Education Center of Wake Forest University School of Medicine provides and supports educational activities and services with a focus on primary care in rural communities and those with less access to resources to recruit, train and retain the workforce needed to create a healthy North Carolina. [Learn More](https://school.wakehealth.edu/Education-and-Training/Continuing-Professional-Education/Northwest-AHEC) # Links - [Course Catalog](http://nwahec.org/) - [Join Our Email List](https://share.hsforms.com/16F72ZaBBRBqAda7M--9l9w4ewk6) - [About Northwest AHEC](https://school.wakehealth.edu/education-and-training/continuing-professional-education/northwest-ahec) - [Continuing Education Services](https://school.wakehealth.edu/education-and-training/continuing-professional-education/northwest-ahec/continuing-professional-development) - [Contact Support](https://go.northwestahec.wakehealth.edu/support) # Contact Us [ahecmktg@wakehealth.edu](mailto:ahecmktg@wakehealth.edu) Medical Center Boulevard Winston-Salem, North Carolina Copyright 2026 | Designed by [HubSpot](https://www.hubspot.com) ```json { "@context" : "https://schema.org", "@type" : "BlogPosting", "author" : { "@type" : "Person", "name" : "Practice Support Team", "url" : "https://go.northwestahec.wakehealth.edu/practicesupport/author/practice-support-team" }, "dateModified" : "2021-07-14T20:30:00.923Z", "datePublished" : "2021-07-14T20:30:00.000Z", "headline" : "​COVID-19 Vaccine: Update on Vaccination Counseling Code Reimbursement  ​", "mainEntityOfPage" : { "@id" : "https://go.northwestahec.wakehealth.edu/practicesupport/covid-19-vaccine-update-on-vaccination-counseling-code-reimbursement", "@type" : "WebPage" }, "publisher" : { "@type" : "Organization", "logo" : { "@type" : "ImageObject", "url" : "https://go.northwestahec.wakehealth.edu/hubfs/WFUSM_NWAHEC%20Cobranding%20Logo_H_RGB.png" }, "name" : "Northwest Area Health Education Center (NWAHEC)" } } ```