Medicare_Carriers_Manual / 4480 / 4480.6_Roster_Billing.--

Why This Topic Matters

Roster billing affects how certain vaccination claims are prepared, submitted, and processed under Medicare. Understanding the article helps billing teams recognize the applicable form elements, documentation expectations, and administrative handling rules for these claims.

Article Sections

1. Overview of roster billing

   Introduces the roster billing process for Medicare mass immunization programs and describes its general purpose and scope.

2. Provider enrollment criteria

   Addresses the provider type used for mass immunizers and the enrollment expectations tied to roster billing participation.

3. Modified Form CMS-1500

   Describes the use of a modified claim form and the required information to complete it for roster billing submissions.

4. Roster claim form

   Explains the roster attachment and the minimum beneficiary and provider data elements associated with these claims.

5. Processing, submission, and retention

   Covers claim processing workflow, electronic submission formats, handling of certain incorrectly submitted claims, and record retention expectations.