• Medicare now covers the 20-valent pneumococcal conjugate vaccine

    Medicare began covering the new 20-valent pneumococcal conjugate vaccine on Oct. 1.

    The Centers for Medicare & Medicaid Services suggests submitting separate claims for this vaccine using CPT code 90677, “Pneumococcal conjugate vaccine, 20 valent (PCV20), for intramuscular use.” Don’t forget to also report the appropriate CPT code for administration of the vaccine.

    Part B Medicare administrative contractors began processing these claims on Oct. 4, and will deny claims for shots given July 1–Sept. 30 (before the vaccine was covered by Medicare). 

    — Kent Moore, Senior Strategist for Physician Payment

    Posted on Oct. 14, 2021 by Kent Moore

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