Bills Submitted by Hospices and Payment Procedures for Renal Dialysis Facilities (RDF) (Rev. 1586, 10-06-08)

by  Jared Staheli
June 25th, 2015

Hospices can provide the influenza virus, pneumococcal, and hepatitis B vaccines to those beneficiaries who request them including those who have elected the hospice benefit. These services may be covered when furnished by the hospice. Services for the vaccines should be billed to the local carrier/AB MAC on the Form CMS-1500. Payment is made using the same methodology as if they were a supplier. Hospices that do not have a supplier number should contact their local carrier/AB MAC to obtain one in order to bill for these benefits.

FIs/AB MACs pay for pneumococcal, influenza virus, and hepatitis B virus vaccines for freestanding Renal Dialysis facilities (RDFs) based on the lower of the actual charge or 95 percent of the average wholesale price and based on reasonable cost for providerbasedRDFs. Deductible and coinsurance do not apply for influenza virus and pneumococcal vaccines. FIs/AB MACs must contact their carrier/AB MAC to obtain information in order to make payment for the administration of these vaccines.

Deductible and coinsurance apply for hepatitis B vaccine.

References:

Bills Submitted by Hospices and Payment Procedures for Renal Dialysis Facilities (RDF) (Rev. 1586, 10-06-08). (2015, June 25). Find-A-Code Articles. Retrieved from https://www.findacode.com/articles/bills-submitted-by-hospices-and-payment-procedures-for-renal-dialysis-facilities-rdf-rev-1586-10-06-08-26902.html

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