Billing

Preventive Vaccines for FQHCs and RHCs Guidance

Effective 7/1/2025, FQHCs and RHCs will bill and receive payment for all four types of Part B preventive vaccines (pneumococcal, influenza, COVID-19 and hepatitis B) and their administration at the time of service.

Summary of Changes

  • Part B preventive vaccines and their administration will be billed on the UB-04 claim form (TOB 77X or 71X).
  • A visit/encounter or qualifying visit code is NOT required to be reported on the same claim as these Part B preventive vaccines to receive separate reimbursement.
  • Use HCPCS Level II code M0201 to bill for the additional payment for administering the vaccine to Medicare patients in their homes under certain circumstances.
  • The roster billing process will be updated to allow entry for TOB 77X and 71X
  • Separate payment will be made at the lesser of 95% of the AWP or the submitted charges for service lines reporting Part B preventive vaccine products when reported on TOB 77X or 71X.
  • A separate payment at the lesser of the MPFS rates or the submitted charges for service lines reporting Part B preventive vaccine administration codes will also be made.
  • Beneficiary coinsurance and deductible will be waived for Part B preventive vaccine products and administration.

Billing Instructions

Bill on FQHC TOB (77X) or RHC (71X) claim

  • Report condition code A6
  • Report appropriate administration code with revenue code 0771
    • G0008 – influenza
    • G0009 – pneumococcal
    • G0010 – hepatitis B
    • 90480 – COVID-19
    • M0201 – in-home vaccine administration (reported in addition to administration code)
  • Report the appropriate Part B vaccine code with revenue code 0636
  • Report ICD-10-CM code: Z23

Special Instructions for FQHCs

  • May be billed alone or with FQHC qualifying visit
    • If qualifying visit occurs on the same day as a preventive vaccine, report the vaccine on the claim in addition to the FQHC payment code (G-code) and qualifying visit
      • Report condition code A6 so that coinsurance is not applied to the preventive vaccine
    • If no qualifying visit occurs, submit the preventive vaccine claim (77X TOB) with the appropriate revenue codes and CPT/HCPCS codes for the administration and vaccine for payment to be made

Special instructions for RHCs

  • Qualifying visit not required to be billed on vaccine claims
  • RHC claims are not required to report the CG modifier on the vaccine or administration line

Cost Report

Although paid on the claim, RHCs and FQHCs must reconcile the claim payments with actual vaccine costs, and these services are ultimately reimbursed at 100% of reasonable costs through the cost report.

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Posted 7/1/2025