• Home
  • Update: COVID-19 Resources and Vaccine Information

Update: COVID-19 Resources and Vaccine Information

Blue Cross and Blue Shield of Kansas (BCBSKS) is closely monitoring the details emerging around the long-awaited COVID-19 vaccine. The COVID-19 vaccine initially will be available in very limited doses – but will scale up in production rapidly, allowing for enough supply to vaccinate all. However, the vaccine will be available in multiple phases with Kansas currently in Phase two.

  • Phase one – healthcare workers and residents or patients of long-term care facilities, senior housing or LTC-supported independent living, workers critical to pandemic response continuity  
  • Phase two – persons aged 65+, those living or working in congregate settings, high-contact critical workers
  • Phase three – persons aged 16-64 with severe medical risks, other critical workers
  • Phase four – persons aged 16-64 with other medical risks
  • Phase five – rest of the population aged 16-64  

The most up-to-date information can be found on the Kansas Department of Health and Environment’s (KDHE) website.

Each county, through local health departments, will decide how their limited supply of vaccine doses will be allocated by population groups. The Governor and KDHE recommend for eligible Kansans to contact their local health departments to learn more about what phase of distribution they are in and how to sign up to receive the vaccine.

Important References to Monitor

Billing Information

Coding

The vaccine will be available to all Americans free of charge. The federal government is funding the cost of the vaccine. Certain vaccine providers may charge an administration fee for giving the shot, but that cost will not be passed on to the patient, regardless if they have insurance or not. BCBSKS will cover that cost for our members. Providers will only be able to bill insurance for the administration fee and will need to submit appropriate CPT and diagnosis codes for the administration. Providers will be able to get reimbursed for the uninsured population through a government relief fund.

Please see the following for administration codes for the COVID-19 Vaccine:

  • 0001A
  • 0002A
  • 0011A
  • 0012A
  • 0031A

Please see the following for new COVID-19 diagnosis codes:

  • J12.82
  • M35.81
  • M35.89
  • Z11.52
  • Z20.822
  • Z86.16

For an expanded list of COVID-19 related diagnosis codes, please see our COVID-19 Service Spreadsheet.

Provider and Pharmacy agreements

To receive free supplies of the COVID-19 vaccine(s), pharmacies, retail clinics, providers, and any other site of care receiving and administering COVID-19 vaccines must sign an agreement with the U.S. government. Under the agreement, all registered and approved providers must vaccinate individuals regardless of whether they have health insurance coverage or what type of coverage they have. Providers are prohibited from balance billing or otherwise charging vaccine recipients. Following vaccination, vaccine recipients must be provided with emergency use authorization (EUA) Fact Sheets on the vaccine and vaccination cards. They are required to administer the vaccine in accordance with CDC and ACIP requirements, and must meet storage and recordkeeping requirements ‒ including recording the administration of the vaccine to patients in their own systems within 24 hours and reporting to public health data systems as soon as practical, and within 72 hours.

Issuer Coverage

Pursuant to a recently issued Interim Final Rule by CMS and the Departments of Labor and the Treasury, issuers of non-grandfathered group or individual health insurance coverage are required to provide coverage, without cost sharing, for in-network qualifying coronavirus preventive services, including a COVID-19 vaccine and its administration, and during the COVID-19 PHE, from out-of-network providers as well.

Balance Billing Provisions

Providers that receive the COVID-19 vaccine free from the federal government are prohibited from seeking reimbursement from consumers for vaccine administration costs – whether as cost sharing or balance billing. BCBSKS is covering the cost of the administration fee for members. Providers may only bill insurance plans for the vaccine administration. Please do not include the vaccine code or any charge associated with the vaccine on the claim.

Providers will need to seek reimbursement for the fee for uninsured patients through the Provider Relief Fund.

Importance of Routine Vaccinations During the COVID-19 Pandemic

Routine vaccinations are an essential preventive care service for children, adolescents, and adults (including pregnant women) and should not be delayed because of the COVID-19 pandemic. Providers are being asked to communicate the importance of maintaining or reinitiate routine vaccinations to their patients. Routine vaccination prevents illnesses that lead to unnecessary medical visits, hospitalizations and further strain the healthcare system.

All vaccines due or overdue should be administered according to the recommended CDC immunization schedules during that visit, unless a specific contraindication exists, to provide protection as soon as possible as well as minimize the number of healthcare visits needed to complete vaccination.

Additional Consideration for Influenza Vaccination

During the COVID-19 pandemic, reducing the overall burden of respiratory illnesses is important to protect vulnerable populations at risk for severe illness, the healthcare system, and other critical infrastructure. For the 2020-2021 influenza season, influenza vaccination will be paramount to reduce the impact of respiratory illnesses attributed to influenza in the population and resulting burdens on the healthcare system during the COVID-19 pandemic.

Oxygen Saturations during Telehealth Visit

Many patients are turning to telehealth visits during the COVID-19 pandemic. In order to keep everyone’s health as our top priority, BCBSKS is allowing physicians to use a patient’s oxygen saturations, taken with their personal pulse ox reader, to determine the best way to treat them.

If you have any questions regarding this publication, please contact your BCBSKS provider representative/consultant.

Institutional Providers
Professional Providers