Vaccine Economics

Immunizations are the most cost effective measure for preventing a variety of serious illness and deadly disease.  Lack of access to this essential preventive care leads to poor health outcomes for children, and jeopardizes our system of public health. Without appropriate payment from insurers for immunization acquisition and administration, physicians struggle to provide vaccine services and remain in business. The Texas Pediatric Society recognizes the great importance of fair payment for vaccine services, and is committed to advocating on behalf of physicians in this regard  - as well as providing information to help negotiate fair rates.

RECENT NEWS

On September 1st, chair of the TPS Committee on Administration and Practice Management, Dr. Jason Terk, provided a webinar on using the vaccine administration codes introduced earlier this year (90460 and 90461). Presentation information and resources are below:

Vaccine Administration Counseling Codes: Using 90460 and 90461
Immunization Administration Comparison Tool
Medicaid Clarification on "other qualified health care professional"

VACCINE ECONOMICS

CDC Private Sector Selling Pricing
Calculating Your Vaccine Cost
AAP Business Case for Pricing Vaccines
AAP Business Case for Pricing Immunization Administration
Talking Points
Article: Variation in Provider Vaccine Purchase Prices and Payer Reimbursement (Gary Freed, MD)

RESOURCES FOR CONTRACTING

Vaccine Addendum for Contracts
Checklist to Assess Carrier Contracts
Questions for Contract Negotiation

GROUP PURCHASING

Group purchasing organizations offer physicians a means to obtain discounted rates on vaccines (and often other goods and services) through the power of bulk purchasing. Though TPS does not endorse a specific group, PedsPal is one example of a group purchasing organization run out of Cook Children’s Hospital here in Texas. For a list of other group purchasing organizations operating nationally, please visit group purchasing organizations

CODING

Vaccine Coding Table
Vaccine Administration Coding Information


For more information, please see Pedia Link CME courses on Contract Negotiation with Payers and Immunizations: Best Business Practices at : http://pedialink.aap.org/ped/cme/cme_finder