Immunization Schedule
Provider Type
- Physicians
- Participating Physician Groups (PPG)
- Hospitals
- Ancillary
Following are immunization schedule recommendations.
The Recommended Childhood and Adolescent Immunization Schedule is approved by the Advisory Committee on Immunization Practices (ACIP), the American Academy of Pediatrics (AAP), and the American Academy of Family Physicians (AAFP) and available on the Centers for Disease Control and Prevention website at https://www.cdc.gov/vaccines/schedules/downloads/child/0-18yrs-child-combined-schedule.pdf.
Each encounter with a member is an opportunity to screen immunization status and administer needed vaccines, even if the member is not within the recommended age ranges. This reduces the number of missed opportunities to vaccinate.
The following information applies only to participating physician groups (PPGs) and physicians.
Medi-Cal adult members may obtain routine vaccinations that are not subject to prior authorization (PA) from their participating provider or participating pharmacy. Refer to the Medi-Cal Rx Contract Drug List for applicable PA requirements and utilization restrictions about age or quantity. The Contract Drug List can be found on the Medi-Cal Rx website.
The financial responsibility for adult immunizations is the same for in-network or self-referral to out-of-network providers. When the Medi-Cal member of a capitated participating physician group (PPG) obtains a vaccine from a participating pharmacy, the cost of the immunization is deducted from the PPG's monthly capitation amount in the same manner as other injectable medications that are the PPG's responsibility. PPGs remain responsible for adult immunizations and assume.