Skip to main content

For Medicaid eligible children, the state does not reimburse for the immunizations due to the

Section 1905(a)(13)(B) of the Act is limited to adult vaccines, therefore, the following applies:

  • Children age 18 and under: Vaccines are provided through the VCF program. Therefore, the one percentage point increase does not apply. For this age group, the vaccine administration fee is not eligible for the one percentage point FMAP increase.
  • Individuals age 19 and 20: Vaccines are not available through the VCF program for this age group. This age group may receive the one percentage point increase in FMAP on both the vaccines and the vaccine administration fee.
  • Adults ages 21 and older: Both the Advisory Committee on Immunization Practices (ACIP) recommended vaccines and the vaccine administration fee are eligible for the one percentage point increase in FMAP.
Supplemental Links:
Date
Topic
Affordable Care Act
Sub Topic
Preventive Services
FAQ ID
91566
FAQ Page
Frequently Asked Questions
FAQ Question
For Medicaid eligible children, the state does not reimburse for the immunizations due to the Vaccines for Children (VFC) program. The state only reimburses for the vaccine administration code. Are the administrative codes for children's immunizations eligible for the preventive services federal medical assistance percentage (FMAP) increase under section 4106 of the Affordable Care Act?Can the fee for administration of the adult vaccines receive the one percentage point increase in FMAP?