DATE: Revised July 1, 2024
TO: WVA Providers and Payers
FEE SCHEDULE COVID-19 UPDATE
Since September 14, 2023, COVID-19 vaccines have been available to order from the Washington State Childhood Vaccine Program (CVP) and providers are required to use the WVA Dosage-Based Assessment (DBA) billing process for commercially insured patients under the age of 19. COVID-19 and all other vaccines are found on the WVA Vaccine Assessment Grid.
The CDC has not yet released the COVID-19 CPT and NDC codes for the fall/winter 2024/25 respiratory season. They will be posted to the WVA Vaccine Assessment Grid as soon as the WVA is provided with the information.
Until June 30, 2024, all COVID-19 vaccines have a WVA Vaccine Assessment Grid amount of $105.00 and after July 1, 2024 the WVA Vaccine Assessment Grid amount will be $113.00. Please update your fee schedules.
INFLUENZA UPDATE
The FDA and CDC have switched the influenza formulation from a quadrivalent to trivalent formulation for the fall/winter 2024/25 respiratory season. CDC has not yet released the influenza CPT and NDC codes for the fall/winter 2024/25 respiratory season. They will be posted to the WVA Vaccine Assessment Grid as soon as the WVA is provided with the information.
Until June 30, 2024, all influenza vaccines have a WVA Vaccine Assessment Grid amount that varies. After July 1, 2024 the WVA Vaccine Assessment Grid amount will be $18.00 for all influenza vaccines.
RSV UPDATE
The RSV monoclonal antibody – Beyfortus™ (nirsevimab) – will require the WVA dosage-based assessment (DBA) after July 1, 2024 when Beyfortus™ will be added to the WVA Vaccine Assessment Grid.
CONTACTS
WA DOH CONTACTS FOR PROVIDERS can be found here
WVA CONTACTS:
compliance@wavaccine.org for Payers
info@wavaccine.org for Providers