Update on Shingles Vaccination (previously published 092906): Does Medicare cover Zostavax and its administration?
Effective January 1, 2007, physicians administering a Part D vaccine should bill to their Part B carrier HCPCS code G0377. Medicare will not pay for the vaccine itself. If the beneficiary is enrolled in Part D, payment for the Part D covered vaccine is made solely by the participating Prescription Drug Plan. As of January 1, 2008, HCPCS code G0377 can no longer be billed to Part B. At that time, providers will need to bill the patient for the vaccine and its administration, and the patient will need to submit the claim to the Part D plan for reimbursement. For additional information see the attached CMS articles: • http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM5486.pdf • http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0723.pdf Previous FAQ (question #1 September 2007 issue): • http://www.cignamedicare.com/articles/Sept06/Cope4869.
