KMAP BULLETIN: Prevnar 20 Vaccine Coverage for VFC

Date: 10/27/23

KMAP GENERAL BULLETIN 23268 (PDF)

Effective with dates of service on and after October 1, 2023, the administration of 20-valent pneumococcal conjugate vaccine (PCV20), also known as Prevnar 20, will be covered for persons under 19 years of age.

Prevnar 20 is covered under the Vaccines for Children (VFC) program per the recommendation of the Advisory Committee on Immunizations Practices (ACIP).

Prevnar 20 may be used as an option to the currently available 15- valent pneumococcal conjugate vaccine (PCV15) for children younger than 19 years of age, based on the currently recommended pneumococcal conjugate vaccine (PCV) ACIP dosing and schedule.

The immunization administration code must be accompanied by the appropriate vaccine code for payment.

Note: The effective date of the policy is October 1, 2023. 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.