Fact Sheet on Medicare Vaccine Billing Now Available to LTC Facilities

Published On: April 10th, 2024Categories: Education & ResourcesTags: , , , ,

The Centers for Medicare and Medicaid Services (CMS) has issued a new, two-page fact sheet on various billing scenarios for preventive vaccines administered in nursing homes, which can help facilities capture revenue for provided services.

The resource explains how Medicare pays for Part B– or Part D–covered preventive vaccines administered during a patient’s stay in a skilled nursing center. Payment depends on the type of vaccine and Medicare benefit covering the resident’s stay. This document does not cover vaccine payment by Medicare managed care, Medicaid, or commercial insurance. 

The new fact sheet specifically discusses billing and payment responsibilities associated with the Part D respiratory syncytial virus (RSV) vaccines, and Part B flu, pneumococcal, and COVID-19 vaccines. Links to CMS updates on price and billing codes are provided at the end of the document.  

To view or download the CMS fact sheet, click here.