DATE: September 28, 2023
TO: WVA Providers and Payers
COVID UPDATE
The COVID-19 vaccine commercialization took effect on September 14, 2023. Providers can order vaccines and must, in turn, use the WVA’s Dosage-Based Assessment (DBA) billing process for commercially insured patients under the age of 19. This includes commercial payers and third-party administrators (TPAs). COVID-19 is now no different than any other vaccine covered on the WVA Vaccine Assessment Grid.
The WVA Vaccine Assessment Grid has been updated to include COVID-19 vaccines. Additional COVID-19 vaccines may be added in the future, so please refer to this web page for the most current information. Until June 30, 2024, all COVID-19 vaccines will have a Vaccine Assessment Grid amount of $105.00. It is expected that this will be re-evaluated for any July 2024 Vaccine Assessment Grid updates.
RSV UPDATE
- The RSV monoclonal antibody – Beyfortus™ (nirsevimab) – is not currently part of the WVA Vaccine Assessment Grid.
- There is State-supplied vaccine through the VFC program available for commercially insured patients in Washington State.
- There is State-supplied vaccine through the VFC program available for Medicaid Apple Health patients in Washington State.
- Providers should not bill Beyfortus™ vaccine codes using the WVA’s dosage-based assessment (DBA) process.
WA DOH CONTACT POINTS FOR PROVIDERS can be found here:
WVA CONTACT POINTS:
compliance@wavaccine.org for Payers
info@wavaccine.org for Providers
SUPPORTING DOCUMENTS: