I took this from www.medicare.gov, provider billing manual (chapter: billing for preventitive services) last night:
10.2 - Billing Requirements
(Rev. 1586, Issued: 09-05-08, Effective: 10-06-08, Implementation: 10-06-08)
A Edits Not Applicable to Pneumococcal or Influenza Virus Vaccine Bills and Their Administration
1 Billing for Additional Services If a physician sees a beneficiary for the sole purpose of administering the influenza virus vaccine, the pneumococcal vaccine, and/or the hepatitis B vaccine, they may not routinely bill for an office visit. However, if the beneficiary actually receives other services constituting an â€śoffice visitâ€ť level of service, the physician may bill for a visit in addition to the vaccines and their administration, and Medicare will pay for the visit in addition to the vaccines and their administration if it is reasonable and medically necessary.
As far as the co-pay, I would think that copays are E&M specific: butIwould review a patient's benefits online with an insurance to double check. Hope this helps!
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