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Influenza Vaccines and Hospice

Hospice providers may submit claims to CGS for vaccines with dates of service on or after October 1, 2016, (see MM9052).  Because vaccinations are not part of the Medicare hospice benefit, hospice claims (type of bill 81X or 82X) for vaccine services must be billed on a separate claim and must only include charges for the vaccine and their administration.  Refer to the Special Claims Filing Situations on the Hospice Claims Filing Web page for additional billing information.

For vaccines provided prior to October 1, 2016, Hospices bill and are reimbursed for these vaccines under Medicare Part B by the the Part B carrier/ Part B Medicare Administrative Contractor (MAC). Payment is made using the same methodology as if they were a supplier. Hospices that do not have supplier billing number(s) should contact their local Part B carrier/MAC to obtain one. Once you obtain a supplier billing number, submit services for the influenza virus vaccine to your local Part B carrier/MAC for payment.

Posted: 09.30.16

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