November 10, 2021
Effective January 1, 2022, the Centers for Medicare and Medicaid Services will change the way physicians bill and are paid for COVID-19 vaccine administration services for Medicare Advantage enrollees. For Medicare Advantage patients vaccinated on or after January 1, 2022, COVID-19 vaccine administration claims should be submitted to the patient’s Medicare Advantage plan. Fee-for-service (FFS) Medicare will no longer pay these claims.
Currently and for services provided through the end of 2021,Medicare Advantage claims must be submitted directly to Noridian, the Medicare FFS Administrative Contractor in order to be paid.
The California Medical Association (CMA) has published several resources including CMA’s COVID-19 Vaccine Reimbursement Quick Guide and COVID-19 Vaccine Toolkit for Physician Practices to provide answers to frequently asked physician questions about the COVID-19 vaccine rollout and billing guidance on administration of the vaccine. Both resources are updated frequently with the latest information regarding COVID-19 Vaccines.
If your practice has questions regarding COVID-19 vaccine billing or is experiencing reimbursement challenges, please contact CMA at EconomicServices@cmadocs.org or at (888) 401-5911.