UPDATE TO MEDICARE REIMBURSEMENT RATES FOR VACCINATIONS |
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Different Medicare provider types are reimbursed under different payment methods. This bulletin applies to physicians and qualified non-physician practitioners submitting claims to Carriers/AB MACs.
For a seasonal flu or pneumococcal vaccination, there is an administration component and vaccine component to be billed to Medicare Part B. The administration is billed using diagnosis code V04.81 for influenza, V03.82 for pneumococcal, or V06.6 for both influenza and pneumococcal, and HCPCS Code G0008 for influenza administration and HCPCS Code G0009 for pneumococcal administration. Reimbursement is based on the Medicare Physician Fee Schedule amounts and is subject to the lower of the fee schedule amount or billed charges. If the charges are less than the fee schedule amount below, then reimbursement will be at the lower charged amount. Read full article.
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Physician Practice 