Simplified Billing for Influenza Virus and Pneumococcal Vaccine Services by HHAs (Rev. 1586, 10-06-08)

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.

References:

Simplified Billing for Influenza Virus and Pneumococcal Vaccine Services by HHAs (Rev. 1586, 10-06-08). (2015, June 25). Find-A-Code Articles. Retrieved from https://www.findacode.com/articles/simplified-billing-for-influenza-virus-and-pneumococcal-vaccine-services-by-hhas-rev-1586-10-06-08-26911.html

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