Wiki Vaccine Supervision

[aschaeve]

When a patient receives a vaccine in an office setting, the supervising physican needs to be "immediately available". Correct? Where can I find this in writing? Are there any vaccines such as Covid, Flu, or pniumoccocal thatn can be given without supervision--in an office setting with no physician present?

Thanks,

Alicia Schaeve, CPC

 

[thomas7331]

No, I don't believe that's correct. It's my understanding that vaccines are one of the services that are exempt from the supervision and other 'incident to' rules that apply to most non-preventive medical services. When administered as a routine service not directed at the treatment of an illness or injury, vaccines can be administered under 'standing orders' and don't require a physician order or supervision. For example, many pharmacies offer vaccines which are covered by payers and don't require that a physician be on site.

 

[Cynthia Hughes]

To verify that no supervision is required, see the Medicare Claims Processing Manual (cms.gov/manuals online only manuals 100-04, Chapter 12, section 10.1.2) for the following.
"Effective for services furnished on or after May 1, 1993, the influenza virus vaccine and its administration is covered when furnished in compliance with any applicable State law. Typically, this vaccine is administered once a flu season. Medicare does not require for coverage purposes that a doctor of medicine or osteopathy order the vaccine. Therefore, the beneficiary may receive the vaccine upon request without a physician’s order and without physician supervision. Since there is no yearly limit, A/B MACs (A) and (B) determine whether such services are reasonable and allow payment if appropriate."

Similar language applies for the pneumococcal vaccine.

No at all services performed by clinical staff are subject to the incident-to requirement for in-office supervision. For instance, venipuncture falls under the supervision requirements for diagnostic services.

Hope that helps.
Cindy