Immunizations

Written by Norene Anderson
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Immunizations are an important contribution to living a long healthy life. The decision to have adult immunizations such as influenza and pneumococcal vaccines is easy. The difficulty comes with filing the charges to Medicare. The administration and billing procedures and principals can vary from one state to another. The local Medicare office is a great resource to know what is accepted and what is not accepted in your state.

The reimbursement rate paid by Medicare for the influenza, hepatitis B, and pneumococcal vaccinations has not increased to keep up with the cost. Many physicians are no longer offering immunization due to the losses to be absorbed. One reason stated for the low reimbursement is the way the CMS requires immunizations to be billed. The code indicates a link to the CPT (Current Procedural Terminology) code for therapeutic injections.

The Importance of Immunizations

Immunizations are one of the mainline entries to preventing serious illness. The elderly, the very young, and those with compromising health issues are at risk for the flu or pneumonia. The number of people hospitalized for complications from the flu is at least 100,000 every year. There are nearly 65,000 deaths from pneumonia and influenza. Many of these could have been prevented with the right immunization.

Statistics are showing the flu season is beginning earlier and lasting longer. It is a serious concern of physicians and healthcare providers. Providing the immunizations is crucial to lowering the risks to the elderly. Low reimbursement for services rendered is an obstacle that many physicians and healthcare organizations are working diligently to resolve.


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