AAPC - Back to school
Results 1 to 3 of 3

Thread: Tdap and Medicare

  1. #1

    Default Tdap and Medicare

    AAPC: Back to School
    I just got a call from a patient saying that the Tdap vaccine was now covered by Medicare. I know this is true for pharmacies, but has that also changed for medical offices? I've been submitting Tdap claims to Medicare having the patient sign and ABN and I have yet to see Medicare pay for one. Anybody able to help with this?

  2. #2
    Join Date
    Apr 2007

    Default Tdap

    "CDPH received clarification on coverage of the pertussis booster vaccine (Tdap) from
    the Centers for Medicare and Medicaid Services (CMS) regarding coverage of Tdap
    immunization for beneficiaries. Tdap vaccine is a Part D covered drug for use in
    patients 65 years of age and older. Tdap vaccine may be obtained by Medicare Part D
    beneficiaries from a network pharmacy without out-of-pocket costs by the beneficiary.
    Tdap may also be provided in a network provider’s office; however, this would require
    the beneficiary to pay for the vaccine costs up front and then be reimbursed by their
    Medicare Part D plan. The beneficiary should contact their Medicare Part D plan in
    advance for detailed instructions on reimbursement for Tdap vaccination."

    "CMS reminds Part D sponsors that the Tdap vaccine is a Part D covered drug and is on-compendia for use in patients 65 and older. The Tdap vaccine may be obtained from a network pharmacy and administered by a pharmacist registered for vaccine administration or in a network provider’s office. This will benefit members by providing a choice in access and administration to the vaccine."

  3. #3

    Smile tdap w Medicare

    You do have the option of signing up for an eDispense account and bill the patients Part D for the tdap and administration.

Similar Threads

  1. Tdap
    By Stephanie.Silva in forum Medicare Regulations
    Replies: 0
    Last Post: 06-22-2015, 09:10 AM
  2. Admin Code for TDAP for Medicare
    By jbittner261 in forum Billing/Reimbursement
    Replies: 3
    Last Post: 02-21-2014, 01:45 PM
  3. Tdap shot for Medicare
    By henimercer in forum Employment General Discussion
    Replies: 7
    Last Post: 11-09-2012, 07:18 AM
  4. TDAP Immunizations/Medicare
    By Dawn Ruiz in forum Family Practice
    Replies: 4
    Last Post: 09-20-2011, 08:27 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.