Medicare Billing for COVID-19 Vaccine Shot Administration

The Centers for Medicare & Medicaid released new information on how to bill for COVID-19 vaccine shots. Below is a breakdown of how to make sure you are billing correctly.

Billing for COVID-19
  • Physicians can bill on single claims for COVID-19 shot administration or submit claims on a roster bill for multiple patients at one time.
  • As the government provides COVID-19 vaccine doses without charge, it is essential to bill the vaccine administration. Do not include the vaccine codes on the claim when the vaccines are free.
  • If you participate in a Medicare Advantage Plan, submit your COVID-19 claims to Original Medicare for all patients enrolled in Medicare Advantage in 2020 and 2021.
How to Submit Institutional Claims

Five shots must be administered simultaneously to use institutional claims unless the institution is an inpatient center. Below are valid types of bills for roster billing.

  • 12X, Hospital Inpatient
  • 13X, Hospital Outpatient
  • 22X, Skilled Nursing Facility (SNF) covered Part A stay (paid under Part B) & Inpatient Part B
  • 23X, SNF Outpatient
  • 34X, Home Health (Part B Only)
  • 72X, Independent and Hospital-based Renal Dialysis Facility
  • 75X, Comprehensive Outpatient Rehabilitation Facility
  • 81X, Hospice (Non-hospital)
  • 82X, Hospice (Hospital)
  • 85X, Critical Access Hospital

When it is time to submit a paper claim, first CMS-1450 (UB-04) and then submit roster form for patients (Contact your MAC for this form).

How to submit professional claim

For electronic claims, use PC ACE billing software to submit directly to your MAC. 

First, for paper claims, fill out the health insurance claim form and then submit the roster form for patients (Contact your MAC for this form).

How to submit a centralized bill

For individuals enrolls as a centralized biller, you can submit a professional claim to Novitas, not dependent on who administrated the shots, although you must operate in at least 3 MAC jurisdictions.

Sources: CMS

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