COVID-19 vaccine administration reimbursement at UCCs

Administration of COVID-19 vaccines is covered through in- and out-of-network providers including Urgent Care Centers. However, effective January 15, 2021, in-network Urgent Care Centers (UCCs) are eligible to receive separate reimbursement at the Horizon BCBSNJ Standard Fee Schedule for the administration of COVID-19 vaccines. Horizon NJ Health will continue to reimburse at the Centers for Medicare & Medicaid (CMS) fee schedule.

If the COVID-19 vaccine administration is:

• The only service a member receives during a visit, the vaccine administration will be considered for separate reimbursement
• Provided to a member in addition to other UCC services on the same date, the vaccine administration will be considered reimbursed in the UCC’s global payment

Please note: Horizon NJ Health will continue to reimburse at the Centers for Medicare & Medicaid (CMS) fee schedule.

If you have not done so already, please review the COVID-19 information posted on HorizonBlue.com and HorizonNJHealth.com.

For information on billing and coding, please refer to the CMS COVID-19 Tool Kit.

If you have questions, please contact your Network Specialist.