With school beginning soon, providers are reminded that MO HealthNet covers school/athletic physicals and vaccines for MO HealthNet eligible children and youth.
A physical examination may be necessary in order to obtain a physician's certificate stating that a child is physically able to participate in athletic contests at school. When this is necessary, diagnosis codes Z00.121 or Z00.129, should be used. This also applies for other school physicals when required as conditions for entry into or continuance in the educational process. Use the appropriate Preventive Medicine code (99381-99385 or 99391-99395) with the appropriate modifiers.
Through the Vaccine for Children (VFC) Program, federally provided vaccines are available at no cost to public and private providers for eligible children ages 0 through 18 years of age. Children who meet at least one of the following criteria are eligible for a VFC vaccine:
- MO HEALTHNET ENROLLED—means a child enrolled in the MO HealthNet Program
- UNINSURED—means a child has no health insurance coverage
- NATIVE AMERICAN/ALASKAN NATIVE—means those children as defined in the Indian Health Services Act
- UNDERINSURED—means the child has some type of health insurance, but the benefit plan does not include vaccinations. The child must be vaccinated in a Federally Qualified Health Center (FQHC) or a Rural Health Clinic (RHC).
MO HealthNet enrolled providers must participate in the VFC Program administered by the Missouri Department of Health and Senior Services (DHSS) and must use the free vaccine when administering a vaccine to qualified MO HealthNet eligible children. The administration fee(s) may be billed in addition to a Healthy Children and Youth (HCY) screen, a preventive medicine service, or in addition to an office visit if a service other than administration of a vaccine was provided to the child. Providers enrolled as Rural Health Clinics (RHCs) or Federally Qualified Health Centers (FQHCs) must not bill an additional administration fee for any vaccine.