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Vaccines for Children (VFC) Program Update: JYNNEOS Vaccine (IB25-4)

Date: 01/31/25

Louisiana Healthcare Connections is sharing a reminder about a Vaccines for Children (VFC) Program Update: JYNNEOS Vaccine (IB25-4).

Effective April 1, 2024, the JYNNEOS vaccine (CPT 90611) became commercially available. Providers administering the vaccine should follow the guidelines below when submitting claims:

    Commercially Purchased Vaccine:

  • Submit the claim with the billed amount that reflects the provider’s cost of the vaccine.
  • Reimbursement will be the lower of the billed charges or the fee on file for recipients 19 years of age and older.

    Government-Provided Vaccine Stock:

  • Submit the claim with a $0 billed amount.
  • Reimbursement will be $0 (paid).

Vaccines for Children (VFC) Program Update:

Effective August 1, 2024, coverage for the JYNNEOS vaccine has been extended to recipients 18 years of age under the VFC program. 

  • Claims for VFC-provided vaccine stock should be submitted with a $0 billed amount 
  • Reimbursement will be $0 (paid).

Please ensure proper billing practices are followed based on the source of the vaccine to ensure accurate claim processing.

For questions related to this information as it pertains to Medicaid fee-for-service claims processing, contact Gainwell Technologies Provider Services at (800) 473-2783 or (225) 924- 5040.

Louisiana Healthcare Connections is updating our system to reflect the changes above within 30 days of this notification (Section 2.18.9.5 of the contract). No action is needed by providers and claims will be automaticaly recycled for the immunization fee schedule changes.