Vaccines For Children (VFC) Program Information for Providers

The VFC Program provides all routine vaccines recommended by the Advisory Committee on Immunization Practices (ACIP) at no cost to participating healthcare providers.

The VFC Program Benefits Your Patients and Your Practice

Many parents can’t afford to pay for vaccines on their own. Being a VFC Program provider is a sound investment in your practice and your patients’ health.  Here are some of the benefits of participating in the VFC Program:

  • Reduces your up-front costs because you will not have to pay to purchase vaccines for VFC Program-eligible children.
  • Enables your patients to get the vaccines they need during routine appointments at their regular office.
  • Helps provide quality care to vulnerable children and adolescents.

Enrolling in the VFC Program is a Simple Process

You don’t have to be a Medicaid provider to participate in the VFC Program. Any healthcare provider (including pharmacists) authorized by their state law granting them the authority to administer vaccines by prescription, vaccine protocol, or prescribing authority can be a VFC Program provider. To enroll in the VFC Program:

  • Contact your state/local/territory VFC Program coordinator to request enrollment.
  • Complete and return the State Provider Enrollment forms as soon as possible.
  • Prepare for a site visit to go over the program’s administrative requirements and proper storage and handling of vaccines once you have completed and returned the enrollment forms.

Vaccines Provided by the VFC Program

Vaccines provided through the VFC Program must be administered according to the guidelines outlined by the Advisory Committee on Immunization Practices (ACIP) in VFC Program resolutions. The resolutions represent the rules that providers must follow for administering each specific vaccine under the VFC Program. VFC Program vaccines may also be administered according to State school attendance laws.

Individual VFC Program vaccine guidelines:

Download the FDA’s package inserts for each vaccine.

VFC Program Eligibility Requirements

A child is eligible for the VFC Program if they are younger than 19 years of age and are one of the following:

  • Uninsured
  • Medicaid-eligible or Medicaid-enrolled
  • American Indian or Alaska Native
  • Underinsured

Children without health insurance (Uninsured)

Children who do not have health insurance qualify for vaccines through the VFC Program.

Medicaid-eligible or Medicaid-enrolled children

Children ages 18 years or younger who are enrolled in a Medicaid program or are eligible for Medicaid can receive VFC Program benefits. However, children who are enrolled in a separate CHIP program are considered insured and do not qualify for VFC Program benefits.

For more information on being a Medicare provider under the VFC Program, see “Medicaid Providers Can Enroll in the VFC Program” section.

American Indian or Alaska Native

Children who are American Indian or Alaska Native qualify for vaccines through the VFC Program as defined by the Indian Health Care Improvement Act (25 U.S.C. 1603).

Underinsured children

“Underinsured” is defined as a child:

  • who has health insurance, but the coverage does not include vaccines;
  • whose health insurance covers only selected vaccines (VFC Program-­eligible for non-covered vaccines only);
  • whose health insurance has a fixed dollar limit or cap for vaccines (VFC Program-eligible once fixed dollar amount or cap is reached).

Underinsured children are eligible to receive VFC Program vaccine only through a Federally Qualified Health Center (FQHC), or Rural Health Clinic (RHC) or under an approved deputization provider location agreement.

Children Who Are Not Eligible for the VFC Program

Children whose health insurance covers the cost of vaccinations are not eligible to receive VFC Program vaccines. This also applies if an insurance carrier denies a claim to pay for the cost and administration of the vaccine because the plan’s deductible had not been met.

Administration Fees for VFC Program Vaccines

VFC Program providers cannot charge their patients for any vaccines given to eligible children. However, they can charge for other fees associated with a vaccination appointment. Types of fees a provider can charge:

  • A set or standard fee to administer each vaccine.
  • An office visit fee.
  • Fees for non-vaccine services that occur during a vaccination appointment, like an eye exam or a blood test.

If a parent or guardian cannot afford the fee (per vaccine), this fee must be removed so that they are not charged. A VFC Program provider cannot refuse vaccination for a VFC Program-eligible child due to the parent’s or guardian’s inability to pay for vaccine administration.

VFC Program Providers Are Required to Screen for Eligibility

All VFC Program providers must screen for a child’s eligibility to receive vaccines through the VFC Program and record the screening results during each visit. The patient eligibility screening record provides a means of recording parent responses to VFC Program eligibility questions. The parent, guardian or provider may complete this form. Verification of parent/guardian responses is not required.

Providers may choose to include these screening questions on their existing screening form; however, any changes must include the core screening information listed on the patient eligibility screening record and be approved by the State Immunization Program.

Patient eligibility screening records should be maintained on file for a minimum of 3 years, unless state law/policy establishes a longer period.

Medicaid Providers Can Enroll in the VFC Program

The largest category of children eligible for the VFC Program is Medicaid-enrolled children. If you are a Medicaid Provider, there are many aspects of Medicaid that you should be aware of and how Medicaid and the VFC Program work together.

Each State Medicaid program can set their own policies within the national guideline set by the Federal Government. However, because the VFC Program is funded through the Centers for Medicare and Medicaid Services (CMS), it falls within the Medicaid law. All State Medicaid programs across the United States encourage their participating physicians to enroll in the VFC Program.

Sometimes a parent or guardian may not know whether their child is enrolled with Medicaid. Even if the child does not have health coverage, you can still provide free vaccines and refer them to a State Medicaid Agency to help determine their status. By enrolling as a VFC Program Provider, you will be able to expand your practice in providing free vaccines to children who need them.

Medicaid Reimbursement as a VFC Program Provider

If you are a VFC Program provider who is not a Medicaid provider, you are not required to become a Medicaid provider to receive publicly purchased vaccine. However, you must become a Medicaid provider in order to receive payment from Medicaid for vaccine administration services provided to Medicaid-eligible children. A VFC Program provider cannot charge for vaccine supplied by public sources.

To learn more about the steps necessary to become a Medicaid provider, consult your State Medicaid agency.

Annual Training Opportunities for VFC Program Providers

All VFC providers are required to participate in annual, comprehensive training. VFC providers should check with their state, local, or territorial immunization program regarding requirements.

CDC offers training modules and refresher test options that may fulfill these requirements.

  • Experienced healthcare professionals familiar with VFC and federal storage and handling requirements can opt to take a refresher test to demonstrate their knowledge on these Note: No continuing education credits will be awarded for completing either refresher test.