The California Department of Health Care Services (DHCS) on Monday announced its systems have been updated and are now able to process claims for COVID-19 vaccine administration.

On December 18, 2020, DHCS announced its plan for reimbursement of the administration of the COVID-19 vaccine, but at that time its systems were not yet able to accept the claims. On December 29, 2020, systems were updated to accept claims, but additional updates were needed before those claims could be paid. As of January 25, 2021, DHCS is now able to accept and adjudicate claims for COVID-19 vaccine administration.

Now that the system has been updated, electronic and hard copy claims submitted since December 29, 2020, are now being processed. Claims for the administration of the COVID-19 vaccine that were inadvertently denied or processed incorrectly instead of being put into “pending” status, will be automatically reprocessed via Erroneous Payment Correction (EPC).

Providers submitting vaccine administration claims for beneficiaries who have Other Health Care (OHC) coverage and claims from facilities that fall under the Los Angeles County waiver, will continue to see submissions appear in “pending” status for a period of time. System changes to properly adjudicate these claims are still in process. 

For more information:

• DHCS News Update: COVID-19 Vaccine Administration: Medical and Outpatient Claims Now Adjudicating
• Medicare payment allowances and effective dates for COVID-19 vaccines and administration during the public health emergency
• DHCS COVID-19 vaccine administration policy