Preventative Services FAQs
- Is the administration for the flu and PPV vaccines reimbursed the same way?
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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.
