Flu & Pneumococcal Vaccines: Expanded SNF Enforcement Discretion for Certain Pharmacy Billing

CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS) Special Edition – Monday, September 27, 2021

 

Flu & Pneumococcal Vaccines: Expanded SNF Enforcement Discretion for Certain Pharmacy Billing Effective September 20, 2021, CMS exercised enforcement discretion for Skilled Nursing Facility (SNF) consolidated billing provisions related to flu and pneumococcal vaccines. This allows Medicare-enrolled immunizers, including pharmacies, to bill directly and get direct reimbursement from the Medicare program (including vaccine administration and product), whether these vaccines are administered at the same time (co-administered) with a COVID-19 vaccine or at different times. Visit the SNF: Enforcement Discretion Relating to Certain Pharmacy Billing webpage. Vaccinations for respiratory illnesses reduce the impact and resulting burdens on the health care system during the COVID-19 PHE.  The CDC recommends that patients in post-acute care facilities get the flu vaccine during the COVID-19 pandemic.  Like our newsletter? Have suggestions? Please let us know! The Medicare Learning Network®, MLN Connects®, and MLN Matters® are registered trademarks of the U.S. Department of Health and Human Services (HHS). Paid for by HHS.