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Shingles Vaccination Q: Does Medicare cover Zostavax and its administration?

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Shingles Vaccination Q: Does Medicare cover Zostavax and its administration?

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The vaccine for varicella-zoster was approved by the FDA in May 2006, but Medicare Part B will not be paying for this code under CPT code 90736 (or any other code) or for the associated administration fee. Likewise, providers should not bill an evaluation and management service when the patient is only receiving this injection. Providers may be able to be reimbursed by a patient’s Medicare Part D plan, but this would be subject to each individual plan’s guidelines and, again, is not a Part B paid service at this time.

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The vaccine for varicella-zoster was approved by the FDA in May 2006, but Medicare Part B will not be paying for this code under CPT code 90736 (or any other code) or for the associated administration fee. Likewise, providers should not bill an evaluation and management service when the patient is only receiving this injection. Providers may be able to be reimbursed by a patient’s Medicare Part D plan, but this would be subject to each individual plan’s guidelines and, again, is not a Part B paid service at this time.

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