Corporate

Roster Billing for Mass Influenza and Pneumococcal Pneumonia Vaccines

Roster billing is a quick and convenient way to bill for flu and pneumonia vaccinations. To submit a roster bill, the same type of vaccination must be provided to five or more people on the same date of service. Each type of vaccination must be billed on a separate roster bill. You cannot have pneumococcal pneumonia vaccines (PPVs) and flu vaccines on the same roster bill.

Hospice providers may submit roster bills for vaccines with dates of service on or after October 1, 2016, (see MM9052External PDF). Vaccines may be covered when furnished by a hospice to those beneficiaries who request them, including those who have elected the hospice benefit.

Influenza or pneumococcal pneumonia immunization claims can be submitted individually if you are unable to submit a roster bill. See the Billing Individual Influenza and Pneumococcal Pneumonia Vaccines Web page for more information on submitting individual immunization claims.

To submit a roster bill via direct data entry (DDE), use the Fiscal Intermediary Standard System (FISS) 'Roster Bill Entry' Option 87 from the Claims Entry Menu. Additional information about the FISS Roster Bill Claims Entry Option 87 is available in Chapter Four — Claims and Attachments MenuPDFof the Fiscal Intermediary Standard System (FISS) Guide.

Enter the following coding information when roster billing flu and pneumonia vaccines.

DATE OF SERV Enter the date the vaccine was provided (MMDDYY).
TYPE-OF-BILL

Only key the first 2 digits of the type of bill
34 — Home health outpatient (Part B)
81 – Hospice (nonhospital based)
82 – Hospice (hospital based)

NPI Enter your facilities national provider identifier (NPI)
FAC.ZIP Enter your facility zip code.
REVENUE CODE 0636 for the vaccine
0771 for the administration
HCPCS For a complete list of HCPCS codes for the Influenza Virus Vaccine and Pneumococcal Pneumonia Vaccine, refer to the Medicare Claims Processing Manual (Pub. 100-04), Chapter 18, §10.2.1.External PDF

NOTE: HCPCS code 90471 and 90472 should not be used to bill the administration of the influenza virus vaccine or the pneumococcal pneumonia vaccine. These codes are only used by hospitals billing for the administration of the hepatitis B vaccine.
CHARGES PER BENEFICIARY Enter the charge for each revenue code
ADMIT TYPE Note: In order to access the ADMIT TYPE field in the FISS roster bill screen, you will need to press the Enter key after keying the first beneficiary's Medicare ID number, Last Name, First Name, Birth Date, and Sex code information. After you press ENTER, FISS will allow access to the ADMIT TYPE field for that first beneficiary, and any additional beneficiary information that needs to be entered.

1 — Emergency
2 — Urgent
3 — Elective
4 — Newborn
5 — Trauma
9 — Information not available

In addition, you will need to enter the following patient information for each beneficiary.

  • Medicare ID number
  • Beneficiary's name (first and last)
  • Beneficiary's date of birth
  • Beneficiary's sex (gender)

Additional Resources

Updated: 09.17.19

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