KMAP BULLETIN: Coverage of Vaxelis Vaccine

Date: 07/06/21

KMAP GENERAL BULLETIN 21128 (PDF)

Effective with dates of service on and after June 1, 2021, Current Procedural Technology (CPT) code 90697 should be used for coverage of the vaccine for Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, Haemophilus influenza type B PRP-OMP conjugate vaccine, and hepatitis B vaccine (DTap-IPV-Hib-HepB), such as Vaxelis. These vaccines will be covered for ages six weeks through 4 years of age.

Note: The effective date of the policy is June 1, 2021. The implementation of State policy by the KanCare Managed Care Organizations (MCOs) may vary from the date noted in the Kansas Medical Assistance Program (KMAP) bulletins. The KanCare Open Claims Resolution Log on the KMAP Bulletins page documents the MCO system status for policy implementation and any associated reprocessing completion dates, once the policy is implemented.