• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

1-888-928-2224

info@wavaccine.org

Mailing List Signup

Washington Vaccine Association Logo

Washington Vaccine Association

Facilitating universal purchase of vaccines for all the children of Washington state

  • About
    • Board of Directors
    • Support Staff Members
  • FAQs
  • Calendar
  • For Providers
    • WVA Vaccine Assessment Grid
    • WVA Private Insurance Assessment Billing Provider Guide
    • WVA Inpatient Hospital Provider Billing Guide
    • Provider Resources
  • For Payers & TPAs
    • WVA Vaccine Assessment Grid
    • WVA Health Insurers & TPAs Compliance Guide
    • TPA Registration Requirements
    • Submit a TPA Registration
  • Documents
    • Governance Documents
    • Board & Committee Meetings
    • Assessment Grid History
    • Annual Reports
    • Audited Financial Statements
    • Other Resources and Links
  • Contact

FAQs

Frequently asked questions

Primary Sidebar

Search the FAQs

View All FAQs

The Washington Vaccine Association enables the state to universally purchase childhood vaccines. The WVA collects funds from health insurers and TPAs (payers) via dosage-based assessment process and remits the funds to the state to cover the cost of vaccines for privately insured children. As a result, Washington is able to purchase vaccines for all children at volume rates from the US Centers for Disease Control and Prevention and deliver them to providers at no cost.

General Information

View All FAQs
What is the Washington Vaccine Association (WVA)?

The WVA, is a not-for-profit organization that works in partnership with the Washington State Department of Health, to support the state’s universal Childhood Vaccine Program. The WVA facilitates the funding for vaccines administered to commercially insured children under age 19.

What is the Washington State Childhood Vaccine Program (CVP)?

The CVP is a program that distributes recommended pediatric (children under 19) vaccines to providers at no cost to providers or patients.

How does the WVA ensure access to vaccines for children?

The WVA ensures vaccine access to commercially insured children by collecting financial assessments from health insurers and third-party administrators for administered vaccines. These assessments, in turn, fund the discounted vaccine purchases by the Washington State Department of Health for the CVP.

WVA Dosage Based Assessment (DBA)

View All FAQs
What is the WVA Dosage Based Assessment (DBA)?

The DBA is a financial charge (assessment) submitted by providers through the claims process to health insurers for state-supplied vaccines administered to commercially insured children. This ensures a funding stream to the WVA for the vaccines provided to commercially insured children.

Who must submit a DBA?

Providers enrolled in the CVP and administer state-supplied vaccines to commercially insured children under age 19 must submit a DBA. The DBA is not required for uninsured, Medicaid, Apple Health, Tribal, under-insured served at FQHCs/RHCs, or CHIP-covered patients.

Are patients responsible for any portion of the DBA payment?

No, patients are not responsible for any portion of the DBA payment. The DBAs are submitted and processed without patient responsibility for vaccine costs.

Is there a timely filing limit for submitting a DBA?

No, where the DBA is an assessment, and not a medical claim, there is no timely filing limit for submission. Timely filing denial edits should be removed from the payer adjudication systems.

Providers

View All FAQs
What steps must providers follow to comply with WVA requirements?
  1. Enroll in the WA DOH Childhood Vaccine Program (CVP).
  2. Set up electronic billing systems for DBAs.
  3. Verify and document patient eligibility per DOH requirements for each visit.
  4. Submit the Dosage Based Assessment (DBA) accurately to commercial insurers.
How would providers set up their billing systems to submit DBAs?

Providers need to contact their EMR/billing software vendor to ensure their billing systems and clearinghouse connections are:

  1. Set up accurately to submit the DBAs, and
  2. Updated annually with the correct CPT codes, NDC codes, and vaccine material amounts as per the WVA’s Vaccine Assessment Grid.

Guidance to EMR/Billing software vendors:

  • All DBAs should be electronically submitted to the payer (health insurers and TPAs) using the 837 Professional format.
  • DBAs should not be submitted directly to the WVA. The WVA’s Outpatient and Inpatient Billing Guides and supporting documents are available online.
What steps are necessary by a Provider office if a DBA is denied?

Providers must correct any provider demographic, patient eligibility, or other errors, and then re-submit both the administration claim and DBA to the payer.

Note: If the administration claim is denied, providers should also assume denial of the DBA.

Will my admin claim be denied if the vaccine code isn’t included?

No. Do not include the vaccine codes on your administration claim as this will cause the payer to view the DBA as a duplicate claim and deny payment to the WVA.

Why is the SL modifier not added to the vaccine codes on the DBA?

The SL modifier is NOT used for vaccines funded by the WVA for privately insured children under the age of 19.

The SL modifier is only used for publicly funded vaccines under the federal vaccines for children (VFC) program and the WA state Medicaid CHIP program for children under the age 19 which includes Medicaid, CHIP, uninsured, underinsured, and American Indian/Alaska Native.

While these vaccines are purchased and supplied by the WA state Department of Health at no cost to the provider or the patient, the vaccines are privately funded due to the dosage-based assessments (DBAs) which are charged to private payers and paid to the WVA.

The SL modifier is only used for publicly funded vaccines under the federal vaccines for children (VFC) program and the WA state Medicaid CHIP program for children under the age 19 which includes Medicaid, CHIP, uninsured, underinsured, and American Indian/Alaska Native.

Can providers use discontinued vaccine materials?

Yes, providers can administer vaccine materials that are still viable even if they have been discontinued from previous grids. If the CPT code is not on the current grid, providers should refer to the legacy information at the end of the document and remit the last published assessment amount on the Dosage-Based Assessment (DBA).

Payers and TPAs

View All FAQs
How should payers comply with the WVA DBA requirements?
  1. Understand the basics of the DBA process
  2. Set up adjudication systems correctly.
  3. Follow up on final details to ensure compliance with WVA’s guidelines.

To assist with this, the WVA has developed a Health Insurers & TPAs Compliance Guide.

What should be done if a DBA is incorrectly adjudicated?
  1. Payers should reverse and adjust the payments.
  2. Payers should review their systems to ensure the correct set up to avoid such errors.

Key requirements outlined in the WVA Health Insurers & TPAs Compliance Guide include:

  • The full WVA Vaccine Assessment Grid amount is due to the WVA.
  • There is no patient responsibility.
  • There is no timely filing limitation for DBAs where they are a statutorily created assessment.
  • There are no out-of-network (OON) denials.
  • Working collaboratively with the WVA to resolve any denial or payment issues.
  • Electronic Remittance Advices and ACH Payments are preferred.
  • TPAs are required to register and maintain contact information on the WVA website.
Who needs to register as a TPA and when do I need to register?

Pursuant to RCW 70.290.075, if the clients represented by the TPA offer private health plan or self-funded employer plans that include vaccine material coverage to patients under the age of 19, both state-based and out-of-state TPAs are required to register with the WVA. TPAs are only required to register once.

Troubleshooting and Support

View All FAQs
Who can providers contact about the DBA or CVP enrollment?
  • For DBA process inquiries contact the WVA at:
    • Email: info@wavaccine.org
    • Phone:1-888-928-2224

 

  • For CVP enrollment and vaccine procurement questions, contact the WA DOH:
    • Email: WAChildhoodVaccines@doh.wa.gov
    • Phone: 360-236-2VAX
How can electronic remittances and ACHs be set up with the WVA?

Health insurers and TPAs interested in electronic remittances and/or ACH payments can contact the WVA at EDI@wavaccine.org to set up these services.

How can I stay informed about changes to the CVP and WVA?

Sign up for the WA DOH Vaccine Blurb email list by sending a request to WAChildhoodVaccines@doh.wa.gov.

Whom should I contact for more information regarding compliance?

For questions or assistance, you can contact the WVA at compliance@wavaccine.org.

What are the WVA’s Tax ID and NPI numbers?

The WVA’s Tax ID is 27-2251833 and the NPI is 1699092718.

WVA Vaccine Assessment Grid

View All FAQs
What is the WVA Vaccine Assessment Grid (Grid)?

The Grid contains the per dose assessment rate remitted by payers to the Washington Vaccine Association (WVA).

It includes:

  • CPT code
  • NDC code
  • Vaccine trade name
  • The assessment rate

Note: The assessment rate on the Grid amount should be submitted as the charged amount on the DBA.

How often is the WVA Vaccine Assessment Grid (Grid) updated?

The Grid is updated annually and is in effect from July 1 to June 30 of the following year.

There are sometimes off-cycle Grid changes, which will be communicated by both the WVA and the Washington State Department of Health.

What should providers do to ensure proper DBA submission?

Providers should verify the date of service to ensure the correct grid is used.

  • Check the validity of the CPT code
  • Ensure the correct assessment amount is submitted in the charges field and remitted to the WVA.

Note:  The WVA’s Outpatient and Inpatient Billing Guides and supporting documents are available online.

Can providers use discontinued vaccine materials?

Yes, providers can administer vaccine materials that are still viable even if they have been discontinued from previous grids. If the CPT code is not on the current grid, providers should refer to the legacy information at the end of the document and remit the last published assessment amount on the Dosage-Based Assessment (DBA).

Where can I find the legacy CPT and NDC codes?

The legacy CPT and NDC codes are listed at the end of the WVA Vaccine Assessment Grid document for reference.

Footer

WA Vaccine Association

Washington Vaccine Association
PO Box 94002
Seattle, WA 98124-9402
1-888-928-2224
888-928-2242
info@wavaccine.org

WVA Tax ID: 27-2251833
WVA NPI: 1699092718

Quick Links

  • Home
  • Calendar
  • FAQs
  • About
  • Board of Directors
  • Support Staff Members
  • Mailing List
  • Contact

Document Library

  • Governance Documents
  • Board/Committee Meetings
  • Assessment Grid History
  • Annual Reports
  • Audited Financial Statements
  • Other Resources and Links

Site by Wicked Good Web. Copyright © 2025 Washington Vaccine Association. Return to top