Covid Vaccine Administration & vaccine charges

HeatherDuboisHeatherDubois
in BILLING AND CLAIMS

Good Afternoon-

When billing for the Covid Vaccine Admin charges (0001A, 0002A, 0011A, 0012A, 0022A, & 0031A) we are being asked by some payors to include a token, non-reimbursable charge for the vaccine (91300, 91301, 91302, 91303). Medicare (which usually requires a token charge in our jurisdiction) does not want a token charge for the Covid Vaccines.

We have unsuccessfully gotten a response from United (Commercial) on whether or not they will require the token charge for the vaccine with claims for the admin charge.

Has anyone had any luck with United on this? There reference docs di not answer this, but do cite CMS frequently enough that I am leaning towards no token charge.

Thanks for your thoughts on this!

Comments

  • dwilliamsrsidwilliamsrsi

    CMS has noted in several of the Office Hours calls and in the FAQ document that they will accept a token charge on the claim because they have heard from providers that other insurance companies require this charge. They did agree so that it would decrease some of the operational burden on providers. If your MAC is not allowing the token charge, then you want to direct them to the FAQ document which notes this is acceptable.

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