Wiki Immunization Clinic

[lisaneese]

Our organization is looking to do an immunization clinic at our Children's Clinic location. We would like for both pediatric patients and adults to receive immunizations. Has anyone had success with reimbursement when an adult (possibly Medicare patients) receives a vaccination at a pediatric facility (by a pediatrician)?

 

[thomas7331]

Our organization is looking to do an immunization clinic at our Children's Clinic location. We would like for both pediatric patients and adults to receive immunizations. Has anyone had success with reimbursement when an adult (possibly Medicare patients) receives a vaccination at a pediatric facility (by a pediatrician)?

If your provider is enrolled with Medicare and if the particular immunization is a covered benefit, then you should have no problem with getting reimbursed for this. You'll need to bill the administration with the HCPCS code (G code) that Medicare requires rather than the CPT code. Medicare only covers certain immunizations though (e.g. flu shots, hepatitis B, pneumovax), but if the patient is on a Medicare Advantage plan or has a supplemental plan, they could have additional benefits for other services beyond what Medicare covers.