Dispensing Pharmacy Notification for State-Supplied Vaccines

October 2021

For the 2021-2022 influenza season, Neighborhood will now require pharmacies to use Rhode Island state-supplied vaccines for influenza immunizations for Medicaid and Commercial Members.

How to bill for state-supplied vaccines

  • Submit Professional Code: MA
  • Place Coordination of Benefits or CB Code: 15
  • Bill for zero ($0.00) ingredient cost
  • The pharmacy will be reimbursed for the administration of the vaccine.

How to bill if utilizing pharmacy-purchased vaccines due to NO availability of state-supplied vaccine

  • Submit Professional code: MA
  • The claim will reject “If No State Supplied Vaccine Available; call 800-364-6331”
  • Call the CVS Pharmacy Help Desk (800-364-6331) and an override will be provided.
  • Pharmacy will be reimbursed for the vaccine product and administration of the vaccine.

Incorrect billing of state-supplied vaccine will yield rejections such as:

  • Covered under medical plan only,” if professional code and CB code not submitted. Claim must be submitted with the following:
    • Submit Professional Code: MA
    • Place Coordination of Benefits or CB Code: 15
  • “$0 ingredient cost required for free product,” if ingredient cost is not zeroed. Claim must be submitted with the following:
    • Submit with zero dollar ($0.00) ingredient cost