Tips to Keep Your Flu Shot Billing Simple

Tips to Keep Your Flu Shot Billing Simple

Intermediary warns that you shouldn't bill separately for vaccination supplies

With fall comes flu season and a sea of questions about billing flu vaccinations.

Here are some tips to keep your flu shot billing simple:

Tip 1: Medicare covers only one flu vaccination per flu season per beneficiary, unless a doctor notes in the medical record that an additional vaccination is reasonable and medically necessary, the CMS said in an MLN Matters article about the vaccinations (SE1026, September 15, 2010).

You can actually follow this rule and still vaccinate a patient twice in a single year. For instance, a beneficiary could receive a flu shot in January 2010 for one flu season, then in November 2010 for the next flu season.

Tip 2: Medicare pays for the vaccine administration, regional intermediary Palmetto GBA notes in a FAQ on its website. The cost associated with the syringe and supplies are included in the administration fee and not separately billed.

Tip 3: Do not charge beneficiaries a co-pay or deductible. Even if you are not furnishing vaccinations in a flu shot clinic or other non-home setting, you still do not need to charge a coinsurance or deductible for the preventive service. In its place, Medicare for the cost of the vaccination and its administration. Remember that Medicare allows for roster billing when you administer the flu vaccine to a number of beneficiaries at one place.

Important: Medicare beneficiaries normally fall into a high risk category for flu, which is why every beneficiary is encouraged to be vaccinated every flu season. If your office doesn't have the vaccine available, refer Medicare patients to 1-800-MEDICARE (1-800-633-4227) for help locating their state health department.

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