Pneumococcal Vaccine (Rev. 3159, 02-02-15)

by  Jared Staheli
June 25th, 2015

Section 1861(s)(10)(A) of the Social Security Act and regulations at 42 CFR 410.57 authorize Medicare coverage under Part B for pneumococcal vaccine and its administration. Medicare does not require for coverage purposes, that a doctor of medicine or osteopathy order the pneumococcal vaccine and its administration. Therefore, the beneficiary may receive the vaccine upon request without a physician’s order and without physician supervision.

See Pub. 100-02, Medicare Benefit Policy Manual, chapter 15, section 50.4.4.2 for complete coverage requirements for pneumococcal vaccine.

References:

• Pub 100-04 Medicare Claims Processing Manual - Chapter 18