Can a provider administering a Part D vaccine charge the beneficiary a separate administration fee?
During 2007: During 2007 a separate claim must be submitted under Part B for the administration of a covered Part D vaccine. Payment under Part B for administration of a Part D-covered vaccine is available only if the Medicare beneficiary is enrolled in a Part D Prescription Drug Plan and only if the Part D-covered vaccine is furnished to the beneficiary. CMS has created a G code (G0377: Administration of vaccine for Part D drug) to be used for the administration of Part D-covered vaccines in 2007. The Part B allowed charge for G0377, effective for 2007, is $19.33. Thus, the Medicare payment would be 80% of that amount or $15.46, assuming the beneficiary’s Part B deductible is met. The beneficiary would pay $3.87 as a coinsurance payment, plus any Part B deductible payment that may be due. Starting January 1, 2008 Effective January 1, 2008, the administration of a Part D-covered vaccine is included in the definition of covered Part D drug under the Part D statute and is required to be
