# Tdap and Medicare



## EMCordone (Nov 18, 2010)

I just got a call from a patient saying that the Tdap vaccine was now covered by Medicare. I know this is true for pharmacies, but has that also changed for medical offices? I've been submitting Tdap claims to Medicare having the patient sign and ABN and I have yet to see Medicare pay for one. Anybody able to help with this?


----------



## jreich3 (Nov 18, 2010)

*Tdap*

"CDPH received clarification on coverage of the pertussis booster vaccine (Tdap) from
the Centers for Medicare and Medicaid Services (CMS) regarding coverage of Tdap
immunization for beneficiaries. Tdap vaccine is a Part D covered drug for use in
patients 65 years of age and older. Tdap vaccine may be obtained by Medicare Part D
beneficiaries from a network pharmacy without out-of-pocket costs by the beneficiary.
Tdap may also be provided in a network provider's office; however, this would require
the beneficiary to pay for the vaccine costs up front and then be reimbursed by their
Medicare Part D plan. The beneficiary should contact their Medicare Part D plan in
advance for detailed instructions on reimbursement for Tdap vaccination."


"CMS reminds Part D sponsors that the Tdap vaccine is a Part D covered drug and is on-compendia for use in patients 65 and older. The Tdap vaccine may be obtained from a network pharmacy and administered by a pharmacist registered for vaccine administration or in a network provider's office. This will benefit members by providing a choice in access and administration to the vaccine."


----------



## DavaAdams (Feb 2, 2011)

*tdap w Medicare*

You do have the option of signing up for an eDispense account and bill the patients Part D for the tdap and administration.


----------

