- Preventive Services Guide
- Medicare Preventive Services Resource Guide
- Alcohol Misuse and Counseling
- Annual Wellness Visit Screening
- Bone Mass Measurements
- Cardiovascular Disease Screening Tests
- Colorectal Cancer Screening
- Counseling to Prevent Tobacco Use
- Depression Screening
- Diabetes Screening
- Diabetes Self-Management Training
- Glaucoma Screening
- Hepatitis B Virus Screening
- Hepatitis B Virus Vaccine and Administration
- Hepatitis C Virus Screening
- Human Immunodeficiency Virus Screening
- Influenza Virus Vaccine and Administration
- Initial Preventive Physical Examination
- Intensive Behavioral Therapy for Cardiovascular Disease
- Intensive Behavioral Therapy for Obesity
- Lung Cancer Screening Counseling and Annual Screening for Lung Cancer with Low-Dose Computed Tomography
- Medical Nutrition Therapy
- Pneumococcal Vaccine and Administration
- Prolonged Preventive Services
- Prostate Cancer Screening
- Screening for Cervical Cancer with Human Papillomavirus Tests
- Screening for Sexually Transmitted Infections and HIBC to Prevent STIs
- Screening Mammography
- Screening Pap Tests
- Screening Pelvic Examinations
- Ultrasound Screening for Abdominal Aortic Aneurysm
- Vaccinations
- Related Articles
- Medicare Preventive Services Resource Guide
- The Annual Wellness Visit
- Medicare’s Annual Wellness Visit in Illinois: Understanding the Benefit and Preventing Denials
- Medicare’s Annual Wellness Visit in Minnesota: Understanding the Benefit and Preventing Denials
- Medicare’s Annual Wellness Visit in Wisconsin: Understanding the Benefit and Preventing Denials
Preventive Services Guide
Hepatitis B Virus Vaccine and Administration
Hepatitis B is a virus that can damage the liver; it is spread through contact with infected blood or body fluids and can be transmitted through sex with an infected person or by sharing injection drug equipment.
Coverage Criteria
Medicare beneficiaries at high risk for contracting hepatitis B are covered, scheduled dosages are required.
High-Risk Factors
- ESRD patients
- Hemophiliacs who receive Factor VIII or IX concentrates
- Clients of institutions for the individuals with intellectual disabilities
- Persons who live in the same household as a hepatitis B virus carrier
- Homosexual men
- Illicit injectable drug abusers
- Persons diagnosed with diabetes mellitus
Intermediate-Risk Factors
- Staff in institutions for the mentally retarded
- Workers in health care professions who have frequent contact with blood or blood-derived body fluids during routine work
Exception: Persons in both of the above-listed groups would not be considered at high/intermediate-risk of contracting hepatitis B, however, if there were laboratory evidence positive for antibodies to hepatitis B. (ESRD patients are routinely tested for hepatitis B antibodies as part of their continuing monitoring and therapy.)
HCPCS/CPT Coding
- 90739: Hepatitis B vaccine (HepB), adult dosage, two-dose schedule, for intramuscular use
- 90740: Hepatitis B vaccine (HepB), dialysis or immunosuppressed patient dosage, three-dose schedule, for intramuscular use
- 90743: Hepatitis B vaccine (HepB), adolescent, two-dose schedule, for intramuscular use
- 90744: Hepatitis B vaccine (HepB), pediatric/adolescent dosage, three-dose schedule, for intramuscular use
- 90746: Hepatitis B vaccine (HepB), adult dosage, three-dose schedule, for intramuscular use
- 90747: Hepatitis B vaccine (HepB), dialysis or immunosuppressed patient dosage, four-dose schedule, for intramuscular use
- 90759: Hepatitis B vaccine (HepB), 3-antigen (S, Pre-S1, Pre-S2), 10 mcg dosage, 3 dose schedule, for intramuscular use (effective for claims with dates of services on/after 1/11/2022).
- G0010: Administration code
Frequency
- Two, three or four doses depending on vaccine or condition
ICD-10 Diagnosis Coding
- Two, three or four doses depending on vaccine or condition
Note: Additional ICD-10 codes may apply. See the CMS ICD-10 webpage for individual CRs and the specific ICD-10-CM codes Medicare covers for this service, and contact your Medicare Administrative Contractor (MAC) for guidance.
Cost Sharing
- Copayment/coinsurance waived
- Deductible waived
Nonparticipating Providers
- Nonparticipating reduction applies
- Limiting charge provision applies
Common Claim Denial Reasons
- Benefit maximum for this time period or occurrence has been reached
Related Content
- CMS IOM Publication 100-02, Medicare Benefit Policy Manual, Chapter 15, Section 50.4.4.2
- CMS IOM Publication 100-03, Medicare National Coverage Determinations (NCDs) Manual, Chapter 1, Coverage Determinations, Part 4, Sections 200-310.1
- MLN® Educational Tool: Medicare Preventive Services
Revised 10/12/2023