National Immunization Awareness Month - August
This annual health observance is a great opportunity to educate seniors and other Medicare beneficiaries about the importance of disease control and prevention through immunization. Vaccine-preventable disease levels are at or near record lows. Yet, many adults remain under-immunized, missing opportunities to protect themselves against diseases such as hepatitis B, seasonal influenza, and pneumococcal disease. The Centers for Medicare & Medicaid Services (CMS) ask all health care providers of Medicare patients to join us during National Immunization Awareness Month to help protect your Medicare patients from vaccine-preventable diseases by encouraging utilization of Medicare-covered immunizations and ensuring those immunizations are up-to-date.
Medicare Part B Immunization Benefits
Medicare Part B provides coverage for seasonal influenza, pneumococcal, and hepatitis B vaccines and their administration for qualified beneficiaries as preventive immunizations. Providers who accept the Medicare-approved payment amount for these services are reimbursed under Medicare Part B.
- Seasonal Influenza Immunization
- Medicare provides payment for the seasonal influenza vaccine and its administration for all people with Medicare, once per influenza season, in the fall or winter. Medicare may cover additional flu shots if medically necessary.
- Pneumococcal Immunization
- Medicare provides payment for an initial pneumococcal vaccine to Medicare beneficiaries who never received the vaccine under Medicare Part B. Medicare covers a different, second pneumococcal vaccine one year after the first vaccine was administered.
- Hepatitis B Immunization
- Medicare provides payment for the hepatitis B vaccine and its administration for beneficiaries at intermediate to high risk of contracting hepatitis B.
For More Information
- CMS Preventive Services Provider Resources webpage - provides preventive services resources, including administration and flu vaccine billing and payment rates for use by mass immunizers and physician practices.
- CMS Medicare Part B immunization billing educational tool - provides information on billing for administration and vaccination of influenza, pneumococcal and hepatitis B viruses.
- CMS Medicare Learning Network (MLN) Preventive Services Educational Tool - MLN educational resource developed by CMS for fee-for-service providers with interactive information on Medicare-covered preventive services, including adult immunizations.
The A/B Medicare Administrative Contractor (MAC) Provider Outreach & Education (POE) developed this document to ensure consistent communication and education throughout the nation on a variety of topics and assist the provider and physician community with information necessary to submit claims appropriately and receive proper payment in a timely manner.
Last Updated Aug 05, 2019