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MedicaidBilling CodesLow impact

KMAP BULLETIN: Stand-Alone Vaccine Counseling and Pharmacists

Kansas Medicaid (KanCare)·KS · Pharmacy, Pediatrics·Provider Bulletin
Effective date
Apr 1, 2025
We identified it
Jun 21, 2026
Days to comply

Summary

Effective April 1, 2025, pharmacists can bill new stand-alone vaccine counseling codes (G0312-G0315) for patients under 21 years old through Kansas Medicaid, but only when counseling and vaccine administration occur on different dates of service. Rates range from $10-20 per code and telehealth delivery is covered.

Action Required

Action needed
By April 1, 2025: Pharmacy billing teams must add new HCPCS codes G0312 ($10), G0313 ($20), G0314 ($20), and G0315 ($10) to billing systems for Kansas Medicaid patients under 21. Ensure systems verify that vaccine counseling and administration occurred on different dates before billing these codes. Update telehealth billing capabilities to include these codes.

Affected Billing Codes

G0312
G0313
G0314
G0315