Billing issues related to COVID-19 vaccines can arise due to various factors, such as insurance coverage, government reimbursement policies, and administrative errors.
The second round of 23-24 updated COVID-19 vaccines are upon us. To try to alleviate issues with billing, CMS has developed a Skilled Nursing Facility (SNF) Fact Sheet: Billing Medicare for Respiratory Vaccines to provide answers to questions regarding vaccine billing for Respiratory Syncytial Virus (RSV) and flu, pneumococcal and COVID-19 vaccines.
This document explains how Medicare pays for vaccines administered during a patient’s stay in a nursing home. Vaccine payment depends on the type of vaccine and whether the patient is using their Skilled Nursing Facility (SNF) Part A benefit. This document doesn’t cover vaccine payment by Medicare managed care, Medicaid or commercial insurance. Please review for any concerns you may have with billing for the 23-24 Updated Covid-19 vaccine.
CMS updates the price and billing codes for vaccines each year. See 2023-24 Medicare vaccine pricing and codes.
Additional Resources:
- Great Plains QIN Electronic Vaccination Log – Excel File
- Great Plains QIN Nursing Home Vaccination Change Package
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