by Jared Staheli
June 25th, 2015
The following billing instructions apply to HHAs that roster bill for influenza virus and pneumococcal vaccines.
• When an HHA provides the influenza virus vaccine or the pneumococcal vaccine in a mass immunization setting, it does not have the option to pick and choose whom to bill for this service. If it is using employees from the certified portion, and as a result will be reflecting these costs on the cost report, it must bill the FI/AB MAC on the Form CMS-1450.
• If the HHA is using employees from the noncertified portion of the agency (employees of another entity that are not certified as part of the HHA), and as a result, will not be reflecting these costs on the cost report, it must obtain a provider number and bill their carrier/AB MAC on the Form CMS-1500.
• If employees from both certified and noncertified portions of the HHA furnish the vaccines at a single mass immunization site, they must prepare two separate rosters, e.g., one for employees of the certified portion to be submitted to the FI/AB MAC and one roster for employees of the noncertified portion to be submitted to the carrier/AB MAC.