CCC Update: Roster Billing for Vaccines

A question from the field arose over roster billing for vaccines (pneumonia and influenza, primarily) in the Commonwealth Coordinated Care (CCC) Program.  Earlier this week, the Department of Medical Assistance Services (DMAS) provided the following information for each of the three CCC Plans:

  • Humana:  instructions for providers to carry out roster billing are found here
  • Virginia Premier:  not allowing roster billing
  • Anthem:  Anthem has not yet received any roster billing, and so cannot confirm that their system can process claims in that way.  They are working with their claims department to insure the ability to process roster claims.

VHCA will provide updates as available on this issue.