Home Health & Hospice Week

Industry Note:

Keep An Eye On 2012 Vaccination Pay Rate

With flu season nearly upon you, it may be time to brush up on your vaccination reimbursement basics.

The 2011 rate for vaccination administration is $26.35, the National Association for Home Care & Hospice reminds providers. Sixty percent of that amount is wage-adjusted based on a provider's CBSA.

CMS has proposed the rate to decrease to $26.24 in 2012, NAHC points out. The administration rate will ultimately be set in CMS's outpatient prospective payment system final rule.

Home health agencies receive reimbursement for the vaccine itself on a reasonable cost basis, NAHC explains. "If, however, an HHA's intermediary believes that the HHA has unreasonably incurred cost for the vaccines --" or otherwise has not been a prudent buyer -- it is up to the HHA to support that it was prudent and that the costs are reasonable," the trade group cautions.

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