Tetanus, Diphtheria and Pertussis (Tdap) Vaccine

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Medical providers who “buy and bill” for the Tdap vaccine should use the Current Procedural Terminology (CPT) code 90715.  For administration of the vaccine, providers should bill CPT code 90471 or 90472, as appropriate. 

Tdap vaccines will also be covered through the pharmacy benefit for adult beneficiaries, so long as a prescription is provided for the vaccine.  Pharmacy providers should submit claims for the Tdap vaccine through the point-of-sale (POS) system. 

Coverage for children through 18 years of age will continue to be provided through the Vaccine for Children (VFC) program.  SCDHHS will continue to reimburse for the administration of age appropriate Diphtheria Tetanus, acellular Pertussis(DTaP) or Tdap vaccinations provided to children when the vaccine is obtained through the VFC program. 

For questions related to VFC or to enroll in that program, Medicaid providers should contact the South Carolina Department of Health & Environmental Control (SCDHEC) at the address included below.

Division of Immunization and Prevention
SC Department of Health and Environmental Control
Mills/Jarrett Complex
Post Office Box 101106
Columbia, SC   29211
(803) 898-0460 or (800) 27-SHOTS (outside of the Columbia area)

This bulletin applies to fee-for-service and Medicaid Managed Care Organizations (MCO’s).  Participants enrolled with a Medicaid MCO are a part of that plan, claims and specific authorization questions should be directed to the participant’s Medicaid MCO.  Claims for participants that reside in either a Medical Homes Network or the Fee for Service program would be billed directly to Medicaid.  If you have any questions regarding this policy, please contact the Provider Service Center at (888) 289-0709.  Thank You for your continued support of the South Carolina Healthy Connections Medicaid Program.

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