So do you do in house billing or use an outside company?
You can just bill the VFC vaccines with the amount you bill private ins. Medicaid will pay $0 and then you adjust the rest. For vaccine admin, you should bill medicaid and private ins the same amount anyway. Medicaid will pay their rate and again you just adjust the rest as usual. For self pay you can charge the patient the vaccine admin fee. Check with your state VFC program - there is probably a max. amount you're allowed to charge. Texas is $13.75 so we charge $13.
If you do well child checks there are many other codes you can bill if you do them - like hearing screen, vision screen, depression screen, developmental screen. Texas medicaid requires all of these for well checks anyway so we have to do them for everyone. Each is not a big amount but they do add up. If you check the Bright Futures periodicity schedule you can see all the screenings that are recommended at each age. ACA plans (which is most ins plans nowadays) have to follow Bright Futures and have to cover all these screenings as preventive, i.e., no patient costshare.
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