CMS.GOV - How To Bill for COVID-19 Vaccine Shot Administration

In preparation of the distribution of the COVID-19 vaccines to the General public, Medicare has published guidelines on how to bill for the administration fee. All administration fees will go to Medicare for payment, even if the patient has a Medicare Advantage Plan. Please make sure your patient access department has this information.

You can get all the details on billing COVID-19 vaccinations on the CMS Website:

https://www.cms.gov/medicare/covid-19/medicare-billing-covid-19-vaccine-shot-administration

For all of our efficientC customers, we already have put an edit in the system to stop claims that are being billed to Medicare Advantage plans. This will assist clients to minimize denials and get it billed correctly the first time.

If we can be of any help as you work these claims, don't hesitate to reach out to the experts at OS, inc or efficientC.