Vaccine/toxoid administration fees for clients birth through 20 years of age will be reimbursed based on the number of state defined components administered per injection.
•The provider must bill an administration fee without a modifier when a vaccine/toxoid with one state defined component is administered. The administration fee billed without a modifier is reimbursed at $8.00 each.
•The provider must bill an administration fee with state defined modifier U2 when a vaccine/ toxoid with two state defined components is administered. The administration fee billed with modifier U2 is reimbursed at $12.00 each.
•The provider must bill an administration fee with state defined modifier U3 when a vaccine/ toxoid with three state defined components is administered, The administration fee billed with modifier U3 is reimbursed at $16.00 each.
Modifier
Description
U2
State Defined Modifier: Administration of vaccine/toxoid with two state defined components
U3
State Defined Modifier: Administration of vaccine/toxoid with three state defined components
Texas Medicaid & Healthcare Partnership CPT only copyright 2007 American Medical Association. All rights reserved.
The provider must bill an administration fee without a modifier when a vaccine/toxoid with one state defined component is administered. The administration fee billed without a modifier is reimbursed at $8.00 each.