Billing and Coding: Medicare Preventive Coverage for Certain Vaccines

Medicare Part B covers COVID-19 vaccines, seasonal influenza (one dose per flu season), pneumococcal vaccines (initial dose if never received under Part B and a different second dose ≥1 year later), hepatitis B only for specified intermediate-to-high risk groups, and certain other vaccines (rabies, tetanus) only when directly related to injury or exposure. Claims must include specified HCPCS and diagnosis codes (e.g., G0008/G0009/G0010 and ICD-10 Z23 or Z20.3) and follow product- and date-specific coding guidance where noted.

"COVID-19 vaccines are covered under Medicare Part B (see CMS guidance for vaccine pricing and coding)."

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