Payment for Part D covered vaccines and their administration are made solely by the participating Prescription Drug Plan. This includes all preventive vaccines not covered under Medicare Part B.
When providing a Part D covered vaccine to a Medicare patient, the physician should charge the patient for the vaccine and its administration. To facilitate the patient's reimbursement by his or her Part D plan, the physician's office should complete a CMS-1500 claim form for the vaccine and administration service and give it to the patient to file as an unassigned, out-of-network claim.
Some patients may also request a prescription for preventive vaccines and their administration to meet their Part D plan requirements to have this prescription filled by contracted providers (pharmacy and injection clinic).
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Medicare Part D Vaccine Coverage
Coding for Vaccines and Administration
Administration Coding Changes 2011
Tips for Reporting Vaccinations
Medicare Part B Vaccine Coverage
Medicare Part D Vaccine Coverage
