H1N1 Vaccine HCPCS Codes Released
Two new Level II HCPCS codes were added to the 2009 Medicare Physician Fee Schedule Database (MPFSDB) in the October update. Effective Sept. 1, report code G9142 Influenza A (H1N1) vaccine, any route of administration to describe the H1N1 vaccine itself, and G9141 Influenza A (H1N1) immunization administration (includes the physician counseling the patient/family to describe the administration of the H1N1 vaccine.
Providers should report one unit of G9141 for each administration of the H1N1 vaccine.
Under the MPFS, G9141 and G9142 have been assigned status indicator “X,” indicating these codes represent an item or service that is not within the statutory definition of “physicians’ services” for MPFS payment purposes.
The H1N1 vaccine will be supplied at no cost to providers. Payment for G9141 will be the same as that for G0008 Administration of influenza virus vaccine and G0009 Administration of pneumococcal vaccine, which is currently based on CPT® code 90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); one vaccine (single or combination vaccine/toxoid). Beneficiary copayment and deductible do not apply.
Approximately 50 million doses of H1N1 vaccine are expected to be available by mid-October, according to the Centers for Disease Control and Prevention (CDC).