Correctly Report Hepatitis B Vaccine Admin After April 1

How you should report hepatitis B vaccine administration to Medicare patients in an outpatient facility setting has changed. Beginning April 1, Medicare claims processing systems no longer recognize CPT® codes 90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); 1 vaccine (single or combination vaccine/toxoid) and 90472 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); each additional vaccine (single or combination vaccine/toxoid) (List separately in addition to code for primary procedure) for applying cost-sharing waivers to preventive services.

Report HCPCS Level II code G0010 Administration of Hepatitis B vaccine to ensure your Medicare claims for hepatitis B vaccine administration are processed correctly.

Provisions of the Patient Protection and Affordable Care Act of 2010 (PPACA) waive the coinsurance/copayment and deductible for Medicare covered preventive services recommended by the U.S. Preventive Services Task Force (USPSTF) with a grade of A or B, including hepatitis B vaccine and administration.

The Centers for Medicare & Medicaid Services (CMS) Transmittal 864, Change Request (CR) 7012, rescinds Transmittal 739 to correct the Preventive Services tables and institute this policy change.

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