Coverage of HPV Vaccine for Adults Ages 19-45
The South Carolina Department of Health and Human Services (SCDHHS) will cover the Human Papillomavirus (HPV) 9-valent vaccine for Healthy Connections Medicaid members between the ages of 19-45 beginning July 1, 2023. This coverage applies to full-benefit Healthy Connections Medicaid members and those enrolled in the family planning limited benefit program.
The HPV vaccine is already a covered benefit for Healthy Connections Medicaid members who are between nine and 18 years old. Extending the age range for coverage complies with Section 11405 of the Inflation Reduction Act and aligns SCDHHS’ coverage with the Centers for Disease Control and Prevention (CDC) adult immunization schedule and the Advisory Committee on Immunization Practices (ACIP) vaccine recommendations and guidelines.
Updated policy language will be available in the Physicians Services provider manual on the agency’s website by July 1, 2023.
Providers should direct any questions about this bulletin to the Provider Service Center (PSC) (888) 289-0709. The PSC’s hours of operation are 7:30 a.m. – 5 p.m. Monday – Thursday and 8:30 a.m. – 5 p.m. Friday. Providers may also submit an online inquiry.
South Carolina’s Medicaid managed care organizations (MCO) are responsible for the coverage and reimbursement related to the services described in this bulletin for Healthy Connections Medicaid members who are enrolled in an MCO.