CMS has issued a concise and helpful fact sheet that addresses payment policies associated with administering preventive vaccines to short and long term residents in nursing facilities.
The fact sheet explains how Medicare pays for Part B or Part D covered preventive vaccines administered during a patient’s stay in a nursing home. Vaccine payment depends on the type of vaccine and whether the patient is using their Skilled Nursing Facility (SNF) Part A benefit, including scenarios where the resident is also receiving Medicare hospice benefits. This document doesn’t cover vaccine payment by Medicare managed care, Medicaid, or commercial insurance.
The document specifically discusses billing and payment responsibilities associated with the Part D respiratory syncytial virus (RSV) vaccines, and Part B flu, pneumococcal and COVID-19 vaccines.