NARHC Forum
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| 10/4/2021 @ 12:41:00 PM
Post 1 of 9
Contributor: Amy Gore, Chiefland Medical Center LLC
We are giving the Moderna vaccine and since it was free to us we are charging an administration fee only. Does anyone know if the CPT code for admin fee is 90471 or is there a special admin code for the covid vaccine? 10/4/2021 @ 2:45:00 PM
Post 2 of 9
Contributor: Leigh Boreske, Lake Pediatrics PA
There is a specific CPT for every company and every dose number. For example, we use Pfizer and we use 91300 with $0 charge and use 0001A for administration code for the first vaccine. For the second dose we use 0002A. There are charts online. There are a lot so didn't copy and paste. It is being reimbursed at $40 by medicaid. 10/4/2021 @ 3:11:00 PM
Post 3 of 9
Contributor: Jackie King, ArchProCoding
https://www.cms.gov/medicare/medicare-part-b-drug-average-sales-price/covid-19-vaccines-and-monoclonal-antibodies
Here's the link to the current listing of CPT/HCPCS codes for the COVID-19 related services including vaccines and monoclonal antibodies. Of course these would not be for your Medicare patients as those are going to be billed on a roster like the flu shots. https://www.cms.gov/medicare/covid-19/medicare-billing-covid-19-vaccine-shot-administration Medicare pays for administering COVID-19 vaccines at 100% of reasonable cost through the cost report. RHCs and FQHCs should also use the cost report to bill for administering COVID-19 vaccines to patients enrolled in a Medicare Advantage Plan. Thanks, Jackie [cid:image001.png@01D7B929.8E063C50] Register today for our 2021 Annual Conference on November 18 In Champaign! Jackie King, MSHI, CPC, COC, CRHCP Director of Compliance/Informatics/HIM Phone: 815.875-2999 Mobile: 815.973-9649 Email: jking@icahn.org 1945 Van's Way Princeton, IL 61356 www.icahn.org [A picture containing text, first-aid kit, clipart, vector graphics Description automatically generated] 12/3/2021 @ 7:19:00 PM
Post 4 of 9
Contributor: Christina Pierce, Basin Clinic
Can an RHC bill for the Monoclonal Antibody Treatment or do we have to bill this on the cost report? If it is on the cost report, does anyone have an idea of the reimbursement for that would be? Thanks, Christina Pierce 12/3/2021 @ 7:21:00 PM
Post 5 of 9
Contributor: Christina Pierce, Basin Clinic
Can an RHC bill for the Monoclonal Antibody Treatment or do we have to bill this on the cost report? If it is on the cost report, does anyone have an idea of the reimbursement for that would be? Thanks, Christina Pierce 12/6/2021 @ 11:03:00 AM
Post 6 of 9
Contributor: Michelle Whalley, Ridgecrest Regional Hospital RHCs
Good morning all,
There was a really good NARHC Technical Webinar where they discussed cost reporting process, with a sample log I would look that up for detail. Thanks Michelle [cid:image001.png@01D7EA77.AA643260] 12/6/2021 @ 11:06:00 AM
Post 7 of 9
Contributor: Lori Trokey, Borgess Lee Med Group - Family Practice & Pediatrics
Thank you for your email.
I am currently conducting Athena training. I apologize for any delay in response. I will respond as soon as possible. -- 12/6/2021 @ 1:04:00 PM
Post 8 of 9
Contributor: Kris Keith, Oak Street Health Care Center
There are three separate admin codes for the COVID Vaccine, each is affiliated with the dose administered. I use 0011A for the first dose, 0012A for the second dose, and 0013A for the third. You also want to make sure that you have the CPT code for what brand you use. That is how we have been doing it.
12/6/2021 @ 1:56:00 PM
Post 9 of 9
Contributor: Nathan Baugh, National Association of Rural Health Clinics
Kris, Can you clarify which payer you are talking about here? Billing the vaccine admin fee is not something we are supposed to be doing for Medicare. Instead, as RHCs we are supposed to be adding it to our cost report and getting a lump sum payment to cover cost of admin. Christina, To answer your question, the monoclonal antibody treatment is reimbursed through the cost report, and the reimbursement will be a lump sum payment based on your reported costs. Like vaccine admin, antibody treatments for 2020 and 2021 for both Medicare and Medicare Advantage will be reimbursed through the RHC's cost report. In 2022, only traditional Medicare will be reimbursed through the cost report, and you would bill Medicare Advantage for monoclonal antibody treatment. |
