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Immunization inj and Medicare

  1. Default Immunization inj and Medicare
    Medical Coding Books
    Medicare will not pay for a flu injection unless it has been over 365 days. If a Medicare patient insists on having their injections before the 365 day period has lapsed, can the patient pay cash for their injection?

  2. #2
    Harrisburg PA
    I believe for the flu vaccine it is once per flu season. Therefore a person could receive theflu vaccine in Jan or Feb 2014 and receive it again in Sept- Dec 2014. Separate flu seasons.
    Pub 100-4, chpt 18, section 10.1.2.

    Quick Reference Chart for Immunization

    CMS Q&A
    If a beneficiary gets a seasonal influenza virus vaccine more than once
    in a 12-month period, will Medicare still pay for it?

    Yes, Medicare pays for one seasonal influenza virus vaccination per influenza
    season; however, a beneficiary could get the seasonal influenza virus vaccine
    twice in a calendar year for two different influenza seasons, and Medicare
    would pay the provider for each. For example, a beneficiary could get a
    seasonal influenza virus vaccination in January 2013 for the 2012 ? 2013
    influenza season and another seasonal influenza virus vaccination in
    November 2013 for the 2013 ? 2014 influenza season, and Medicare would
    pay for both vaccinations.

  3. Default
    Thank You

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