Influenza and Pneumonia Vaccinations in the Home Health and/or Hospice Setting

Influenza and Pneumonia Vaccinations in the Home Health and/or Hospice Setting

During the current public health emergency for COVID-19, it is especially important to ensure that all patients are up-to-date with their influenza and pneumonia vaccinations.

Home health agencies can provide the influenza virus vaccine and pneumococcal pneumonia vaccination (PPV) and they are billed on a 341 type of bill (home health outpatient Part B benefit).

Hospice agencies can provide the influenza virus and pneumococcal vaccinations to beneficiaries who request them, including those who have elected the hospice benefit. These services may be covered when furnished by the hospice agency for dates of service on or after October 1, 2016. Vaccinations provided by a hospice agency may be billed on an institutional claim to the Medicare contractor. Since these services are not part of the Medicare hospice benefit, they must be billed on a separate claim and must only include charges for the vaccine and their administration.

Refer to the CGS Billing Individual Influenza and Pneumococcal Pneumonia Vaccines and the Roster Billing for Mass Influenza and Pneumococcal Pneumonia Vaccines web pages for details.