patient asking questions

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:

Q Tips For Your Ears Podcast LogoListen To Our Podcast: Q-Tips For Your Ears!

Vaccines – History, Choice and What We Should Know: Understand the history of vaccines, vaccine safety, and why vaccines are important and how vaccines improve health in the community. Take a few minutes to listen and learn more.

Three shots for Fall – COVID-19, Flu and RSV: Three vaccines those 60+ need for the 2023-2024 Fall and Winter seasons.

Understanding Pneumonia: Pneumonia is an infection that inflames the air sacs in one of both lungs and can cause coughing, fever, chills and difficulty breathing. Join the conversation to better understand the causes and risk factors of pneumonia and how you can treat it.