H1N1 Vaccine Information and Resources

With the busy flu season already underway, there are many lingering questions about the H1N1 vaccine even as the first of the supplies have begun to arrive in health care facilities around the country. Confusion about the H1N1 vaccine can be attributed to a number factors, but the variance in rules from state to state adds an additional layer of complexity. Some states may require you to register in order to administer the vaccine, others may require that you participate in the state's vaccine registry program, and a handful of states are not allowing private practices to administer the vaccine at all.

The CDC has provided a number of helpful resources to assist you in learning about the H1N1 vaccine. If your practice is considering whether or not to administer the vaccine, the CDC has provided a "Decision Tree" that can help inform your decision. As H1N1 continues to spread, safe-guarding children from the virus will require the active participation of many physicians and private care providers in addition to hospitals and other immunization providers.

The CDC has also provided a Web page with links to information in each state for providers considering the H1N1 vaccine. Find out specific information about the requirements and recommendations in your state. Because distribution of the vaccine is handled individually by the state, you will need to go to your state's Web site for information on how to order the vaccine and report vaccine data.

In addition to the confusion about the distribution of the vaccine, there are many remaining questions about how the billing will be handled. The American Medical Association has revised an existing influenza vaccine code, 90663, to include the H1N1 vaccine. Because the vaccine and supplies are covered by the federal government, there is no charge associated with the vaccine itself. The AMA has also issued a new H1N1 vaccine administration code code, 90470, which will have a charge associated with it.

Some private payers will recognize this code and some won't. PCC expects that many practices will have trouble being reimbursed for administering the vaccine. See the CDC's Web page with questions and answers about H1N1 vaccine financing.

PCC recommends that pediatric offices participate in the H1N1 vaccine distribution where possible. Although it may be challenging to meet the demand and costs in providing this vaccination service, consider this an opportunity to provide other clinical services, such as preventive care screening, chronic disease management, etc., which are not only good medicine, but good business.

We will continue to watch for new developments related to the H1N1 vaccine, and will post more information as it becomes available.