Carrier - Vaccines and Vaccine Administration - Coverage Policy for Indian Health Services (Rev. 1040, 09-11-06)

by  Jared Staheli
June 25th, 2015

Pneumococcal Pneumonia Vaccinations

The Medicare Part B program covers PPV and its administration when furnished in compliance with any applicable State law by any provider of services or any entity or individual with a supplier number. This includes revaccination of patients at highest risk of pneumococcal infection. Typically, these vaccines are administered once in a lifetime except for persons at highest risk. See Chapter 18 of Pub. 100-04, Medicare Claims Processing Manual for more information on this benefit.

Hepatitis B Vaccine

The Medicare Part B program provides coverage of hepatitis B vaccine and its administration, furnished to a Medicare beneficiary who is at high or intermediate risk of contracting hepatitis B. See Chapter 18 of Pub. 100-04, Medicare Claims Processing Manual for more information on this benefit.

Influenza Virus Vaccine

The Medicare Part B program covers influenza virus vaccine and its administration when furnished in compliance with any applicable State law by any provider of services or any entity or individual with a supplier number. Typically, these vaccines are administered once a year in the fall or winter. Medicare does not require, for coverage purposes, that a doctor of medicine or osteopathy order the vaccine. Therefore, the beneficiary may receive the vaccine upon request without a physician’s order and without physician supervision. See Chapter 18 of Pub. 100-04, Medicare Claims Processing Manual for more information on this benefit.

References:

• Pub 100-04 Medicare Claims Processing Manual - Chapter 19