Alliance Provider Updates

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COVID-19 Vaccination Administration for Providers

COVID-19 vaccine enrollment and payment process

On the Alliance immunization resources webpage, you will find a flyer breaking down vaccine distribution and reimbursement processes.

We also encourage you to regularly check the COVID-19 Medi-Cal Response page for the latest information and updates.

Enrollment to administer COVID-19 vaccine

As of Jan. 11, providers must enroll in CalVax to administer the vaccine and be reimbursed for the service. Originally, providers were required to enroll in COVIDREADI. Providers already enrolled in COVIDREADI will be automatically transitioned to CalVax.

Note: Enrollment through CalVax is at the provider site level, not the rendering level. Please be sure to complete CalVax enrollment in order to avoid a pending or incomplete application status.

All providers must be enrolled in Fee-For-Service (FFS) Medi-Cal through DHCS in order to be reimbursed for vaccine administration.

Reimbursement for COVID-19 vaccine

In order to receive reimbursement for the administration fee:

  • Directly bill the state when administering the vaccine to Medi-Cal members.
  • Directly bill the Alliance when administering the vaccine to IHSS members.

Information for Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs) and Tribal Clinics

DHCS will pay the applicable Prospective Payment System (PPS)/All Inclusive Rate (AIR) if the vaccination is administered during an in-person visit that meets the requirements of a billable office visit in the clinic setting. If the vaccine administration does not meet all of the requirements of a billable visit (i.e. only vaccine administration), the FQHC, RHC and Tribal Clinic can bill Medi-Cal FFS for administering the COVID vaccine.

For additional questions, contact the Provider Relations team at 800-700-3874, ext. 5504.