Preventive Vaccines and Their Administration on the Claim for Rural Health Clinics and Federally Qualified Health Centers

Published 03/18/2025

Payment for Part B Preventive Vaccines and Their Administration on the Claim for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs)

The purpose of Change Request (CR) 13923 (PDF) is to implement claim-based payments for Part B Preventive Vaccines and their Administration for RHCs and FQHCs, effective for dates of service on or after July 1, 2025. Effective for dates of service on or after July 1, 2025, RHCs (bill type 71x) and FQHCs (bill type 77x), may report all Part B preventive vaccines and their administration — pneumococcal, influenza, hepatitis B and COVID-19 — on the claim.

A visit/encounter is not required for these services; however, if reported on the same day, the vaccines and administrations shall receive a separate payment. Coinsurance and deductible do not apply to these vaccines. Although paid on the claim, RHCs and FQHCs must reconcile the claim payments with actual vaccine costs, and these services are ultimately reimbursed at 100% of reasonable costs through the cost report. 

Additional RHC/FQHC References


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