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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 home health agencies only.
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 bill type 34X, revenue code 0771, diagnosis code V04.81 for influenza vaccination, V03.82 for pneumococcal vaccination, or V06.6 for both influenza and pneumococcal vaccinations, and HCPC Code G0008 for influenza administration and HCPCS Code G0009 for pneumococcal administration. Reimbursement is based on the Hospital Outpatient Prospective Payment System (OPPS) 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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