Preventative Services FAQs
- Is the administration for the flu and PPV vaccines reimbursed the same way?
Yes, the flu and PPV vaccine administrations are reimbused identically. The administration for the flu and the PPV vaccines are reimbursed as follows:
Provider Type Reimbursement for Flu and PPV Hospitals Outpatient Prospective Payment System (OPPS) for hospitals subject to OPPS and reasonable cost for hospitals not subject to OPPS Provider-based RDFs Reasonable Cost SNFs Medicare Physician Fee Schedule (MPFS) Freestanding RDFs MPFS CORFs If the physician administers the vaccine, the claim is submitted to the Part B Carrier, and is reimbursed under the MPFS. If the nurse administers the vaccine, the claim is submitted to the Medicare Administrative Contractor (MAC) using HCPCS G0128 and is reimbursed under MPFS.