Important Updates Regarding Monkeypox Testing and Vaccine Administration
8/10/2022
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Posted by Provider Relations
Fidelis Care is in the process of updating our claims systems to reflect the new codes associated with monkeypox testing and vaccine administration. Please see the guidance below regarding cost-share waivers and billing codes associated with monkeypox for Medicaid, Child Health Plus (CHP), and Essential Plan (EP) programs.
Cost-Share Waivers (Medicaid, CHP, and EP) - Effective July 26, 2022:
- Office visits, including telehealth, for the testing and diagnosis of monkeypox
- Administration of vaccines for exposure to or prevention of monkeypox
Diagnosis Codes
B04 Monkeypox
B09 Unspecified viral infection characterized by skin and mucous membrane lesions
Laboratory Test Code
87593 Infectious agent detection by nucleic acid (DNA or RNA); orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each
Product Codes
90622* Vaccinia (smallpox) virus vaccine, live, lyophilized, 0.3 mL dosage, for percutaneous use
90611* Smallpox and monkeypox vaccine, attenuated vaccinia virus, live, non-replicating, preservative-free, 0.5 mL dosage, suspension, for subcutaneous use
* Codes do not currently have a published rate. Once rates are published, claims will be adjusted for all applicable lines of business.
If you have any additional questions, please contact our Provider Call Center at 1-888-FIDELIS (1-888-343-3547) or your local Provider Relations Specialist.