Updated guidance for Immunizations Covered by Vaccines for Children (VFC)

Anthem providers who administer vaccines to children through 18 years of age should enroll in the VFC program. Anthem will reimburse only the administration fee for any vaccine available through the VFC program.

When submitting claims for vaccines and/or toxoids covered under the VFC program:

• Providers should bill CPT^® 90460 for the administration.
• When administering more than one vaccine, providers should bill the number of vaccines as units:
  • For example, if two vaccines are administered the claim should be billed with an E/M code, two individual vaccines and/or toxoids, and two units of 90460.
• Anthem does not require the SL modifier to be appended.

If you have questions regarding Vaccines for Children, visit the following:

• Ohio Department of Health’s website:
  • Vaccines for Children (VFC) | Ohio Department of Health
• ODM Guidance:
  • Microsoft Word - MAL VFC Policy v2.docx (ohio.gov)
• Anthem VFC policy:
  • OH_CAID_RP_VaccinesforChildren(VC)Program.pdf (anthem.com)