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READER QUESTIONS :

Avoid Billing for Government-Provided H1N1 Drug

Published on Fri Nov 20, 2009

Question: Our practice is planning to offer H1N1 vaccinations. How should we bill for the vaccine and the administration? New York Subscriber Answer: Your billing will depend on the payer.Medicare will cover the administration of the H1N1 vaccine for Medicare Part B beneficiaries as an additional preventive immunization service. CMS created HCPCS code G9141 (Influenza A [H1N1] immunization administration [includes the physician counseling the patient/family]), effective for dates of service on and after Sept. 1, 2009. According to MLN Matters article SE0920, payment will be similar to the administration of the seasonal influenza vaccine. Medicare will pay G9141 with V04.81 (Need for prophylactic vaccination and inoculation against certain viral diseases; other viral diseases; influenza) at the same rate established for G0008 (Administration of influenza virus vaccine). Alternative: The AMA has also issued a new CPT code specific to H1N1 vaccine administration: 90470 (H1N1 immunization administration [intramuscular, intranasal], including counseling when [...]
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