CMS Says Children’s COVID-19 Vaccine Counseling Visits Covered by Medicaid

December 9, 2021


Pader Moua, MPH
Policy Analyst

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On Dec. 2, the Centers for Medicare & Medicaid Services (CMS) announced that Medicaid programs must cover COVID-19 vaccine counseling visits provided to children as part of the Medicaid Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit. This action is part of the Biden-Harris administration’s winter plan to respond to COVID-19 amid the emergence of a new variant of concern, omicron.

COVID-19 vaccine counseling visits will fall under COVID-19 vaccine administration, and as such will be federally matched at 100% under the American Rescue Plan Act. The law was enacted in March 2021 and provides a 100% federal match for COVID-19 vaccines and vaccine administration during the public health emergency and for one year after the end of the emergency. Read more about the American Rescue Plan Act’s health-related provisions in this previous blog post.

Medicaid programs will also be required to cover stand-alone vaccine counseling visits, federally matched at the regular match rate, for all pediatric vaccines under the EPSDT benefit.

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