Hospices Must Enroll in Medicare Part B to Bill for Flu Shots
Monday, October 14, 2013
by: VNAA Policy Team

Section: Public Policy and Advocacy

Hospices that provide influenza, pneumococcal and hepatitis B vaccines to Medicare beneficiaries can bill for them now, but have to be enrolled in Medicare Part B to get reimbursed.  In addition, non-hospice providers cannot bill for buying or administering the vaccines to hospice patients and hospices cannot bill Medicare for this service using the UB04 claim. 

This is problematic for some hospices, however, and some are choosing not to enroll in Part B to gain reimbursement because of the $532 fee they must submit with the application. Previously, reimbursement for these vaccines that were administered to hospice patients had been billed using a home health agency Part A provider number.  But now, hospice must bill for this service using its own provider number, under part B.

To enroll in Medicare Part B, a hospice must obtain a Provider Transaction Access Number (PTAN) to obtain Part B billing privileges.  This involves filling out a CMS-855 B Enrollment Application, a CMS-588 Electronic Funds Transfer Agreement and a CMS-460 Medicare Participating Physician Supplier Agreement.
For more information, visit 2012 – 2012 Immunizers’ Question & Answer Guide to Medicare Part B, Medicaid and CHIP Coverage of Seasonal  Influenza and Pneumococcal Vaccinations.
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