Vermont is a universal vaccine state, providing vaccines to enrolled providers at no cost for use with all patients, regardless of insurance status. The Vermont Vaccine Purchasing Program (VVPP) collects funding from health insurers quarterly based on covered lives. Insurer funding is combined with federal funding to support the purchase of vaccines from the Centers for Disease Control & Prevention (CDC) federal contract at the lowest price. The VVPP began as a pilot program in 2011, and in 2014 legislation passed that ensured a permanent, sustainable universal vaccine program.
As a result of collecting payments from health plans, insurers and other payers, the Vermont Vaccine Purchasing Program makes it possible for:
- Health care providers to receive state-supplied vaccines at no charge
- Children to have easy access to all recommended vaccines
- Adults (19 to 64 years) to have access to all recommended vaccines except flu through their health care provider
- All payers to participate in an efficient, cost-effective system for purchasing and distributing vaccines.
The Health Department has contracted with KidsVax® to create and manage the website that allows health insurers to securely submit their quarterly Vermont covered lives data, generate a report, and prepare an invoice. The website also includes information about the program for health care providers, payers and the public.
Billing for State-Supplied Vaccine
When a Vermont health care provider receives state-supplied vaccine, the Health Care Procedure Coding Systems (HCPCS) National Level II Medicare Code Modifier (SL: State supplied vaccine) must be used when submitting information on claims forms to insurers. All vaccine administration billing must be supported with an accompanying zero ($0.00) or one ($0.01) cent claim identifying the vaccine administered by CPT code a vaccine code, even when there is no amount to be reimbursed. The Vermont Department of Health has no preference regarding whether state-supplied vaccines are billed with a charge of $0.00 or $0.01.
Minutes and Agendas for the VVPP Immunization Advisory Committee are posted on the VVPP website.
For questions regarding the Vermont Vaccine Purchasing Program, please contact the Vermont Department of Health’s servicing agent, KidsVax.org® at 1-855-KidsVax (543-7829) or [email protected]