We have having an issue in some of my clinics regarding the hepatitis B vaccine and Medicare. We realize that Medicare has strict criteria for coverage of the hepatitis B vaccine in the fact that the patient has to be either high or intermediate risk for hepatitis B. The problem is this.....Medicare says that the hepatitis B vaccine must be ordered by a physician, which they further describe as a doctor of medicine or osteopathy (MD or DO) and the vaccine must be administered under a physician's supervison and the ordering physician's info must be included on the CMS-1500 Form. Can a mid-level provider such as a NP or PA order the vaccine? These providers have their own Medicare and of course bill Medicare for their services, so can they actually order the hepatitis B vaccine? To me the language seems pretty clear that order must be from a physician (MD or DO) and performed under a physician supervision, but is there anything in CMS criteria that would exclude a NP or PA from ordering this vaccine? I hope this question makes sense and I am not sounding to dumb here. Thanks.