The Biden-Harris Administration, through the Centers for Medicare & Medicaid Services, now requires states to cover COVID-19 vaccine counseling visits in which healthcare providers talk to families about the importance of kids’ vaccination. Medicaid provides health insurance coverage to over 40% of all children in the United States.
The action will help expand access to individualized medical advice in all communities and give families the support they need to engage with trusted community providers.
CMS will now consider certain COVID-19 vaccine counseling visits for children and youth to be COVID-19 vaccine administration, for which state expenditures can be federally matched at 100% through the last day of the first quarter that begins one year after the end of the COVID-19 public health emergency, under the American Rescue Plan (ARP). CMS will match COVID-19 vaccine counseling-only visits at the ARP 100% federal match rate only when they are provided to children and youth under age 21 as part of the Medicaid Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit.
Additionally, moving forward, CMS will require that states cover stand-alone vaccine counseling visits related to all pediatric vaccines under the EPSDT benefit. These state expenditures will be matched at the state’s regular federal medical assistance percentage.
This action not only underscores the importance of vaccination education but is also a critical step toward protecting families by increasing access to information from providers as they make informed decisions concerning vaccinations for their children.